SGU Episode 776

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SGU Episode 776
May 23rd 2020
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SGU 775                      SGU 777

Skeptical Rogues
S: Steven Novella

B: Bob Novella

C: Cara Santa Maria

J: Jay Novella

E: Evan Bernstein


DC: David Cheeseman, CISSP

Quote of the Week

Mathematical science shows what is. It is the language of unseen relations between things. But to use and apply that language, we must be able fully to appreciate, to feel, to seize the unseen, the unconscious.

Ada Lovelace, early computer programmer

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Show Notes
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Voice-over: You're listening to the Skeptics' Guide to the Universe, your escape to reality.

S: Hello and welcome to the Skeptics' Guide to the Universe. Today is Wednesday, May 20th, 2020, and this is your host, Steven Novella. Joining me this week are Bob Novella...

B: Hey, everybody!

S: Cara Santa Maria...

C: Howdy.

S: Jay Novella...

J: Hey guys.

S: Evan Bernstein...

E: Good evening, folks.

S: And we have a special guest rogue on the show this week, David Chaseman. David, welcome to The Skeptic's Guide.

DC: Great to be here. It's an honour.

S: So, David, you're a patron of the SGU, and that's why you're here with us. But we were just talking before the show how it's amazing, like all of the people that we've had on the show, all of the guest rogues who are patrons, have been awesome. Like they're experts in something, right? So you are like a nuclear engineer or something, right?

DC: Yeah. So I did two and a half years in the submarine Navy as a submarine officer, got qualified on two different reactor designs. So there was the S5W reactor design, which is what they use for training you on land before they put you in a boat that's designed to sink but could sink really far if you don't do things right. And then qualified on S9G, which is the reactor of choice for the Virginia class submarines. And I was actually based in Groton, Connecticut, right at your doorstep. So did that for about two and a half years, got medically disqualified. So I had to cross right into information professional, which does Navy networks, radio communications, and cryptography for basically to keep communications secure on the allied side, so the blue side. And so that's basically what I did. Did that for six years and then punched out to work for a couple startups, which is a serious games company and an AI company. So that's what I do now.

C: Wow. Very cool.

E: Where's my thorium reactor?

DC: Actually, we may get to that later. Who knows?

S: Yeah. Actually, yeah. So you're going to be talking about some nuclear reactor news item later on in the news segment. So how has the COVID-19 pandemic been for your industry?

DC: For the most part, we were really resilient to it. So our office was designed from the beginning to be like, actually, the first company that I started with was remote work from the start, which was a huge win for me in terms of quality of life. And then the second company that I got hired onto, and I work for both concurrently, is designed to be an in-office company, but I was grandfathered in as remote because I live in another state.

C: Oh, nice.

DC: So I'm very lucky and very fortunate that it didn't affect my life too much, and particularly my industry too much, at least within our company.

COVID-19 Update (2:49)[edit]

S: So let's talk a little bit about COVID-19. We've been giving the update every week. We'll start with the numbers. We were just over 5 million cases worldwide, 329,000 deaths. It looks like we're going up by about a million cases a week now last couple of weeks.

J: A million cases a week? You mean globally?

S: Yeah. Globally. Yeah, of course. In the U.S., we were at 92,000 deaths. Of course, this will be higher by the time the show comes out. There's a little bit of a downtrend, but I think we mentioned either last week or the week before that that's entirely because New York State peaked early and it's on the downward trend. If you factor out New York State, the rest of the U.S. is actually still on the increase. But at some point, we have to be getting to the other side of this first wave.

C: Yeah, the problem is now that we're reopening kind of across the country, a lot of experts are saying there's probably going to be a quick second wave just from all of the social distancing, relaxing.

E: Is it better to have that second wave come earlier or have it come later?

C: Well, it's not like, oh, a second wave is bound to come. Until we have a vaccine, this is going to keep happening. We're nowhere near herd immunity. As soon as you relax social distancing, more people are going to get sick. It's just how it works. And I wanted to correct, if that's okay, Steve, something that, because a few people reached out, or maybe not correct, but clarify, a few people reached out, because last week I made an offhand comment about, and I think this might be what the people who reached out were referring to, about the fact that there seems to be a correlation between states that are relaxing social distancing and obviously rates increasing and that a lot of those states are southern states or are more conservative states. I wasn't talking about individual people. I think across the board, the mentality on the show, we've sometimes been a little less careful when we say that people want to get back to work because of isolation fatigue, and that's where a lot of this drive is coming from. And we maybe might've made that seem like that was a partisan issue. Of course, people that are struggling financially across the political spectrum are ready to get back to work. The point I was making is that at a policy level, like at a state level, we're seeing that those are where the correlations are, not that individuals want to.

S: The other thing, I think, that we mentioned in that conversation was the fact that the protests are largely, they're like turf, what do you call that, astroturf kind of movement. They're not really-

C: Grassroots.

S: Yeah, I'm sure there are some people who are legitimate grassroots conspiracy theorists out there who are part of those protests, but we're not talking about just somebody who is pushing back against the idea of continued isolation because it's really financially killing them. We're talking about the people with guns and signs, having armed protests against the government. That those demonstrations-

C: Yeah, saying that this is a mark on their liberty.

S: Yeah, I mean, those demonstrations, we know that those are more orchestrated.

C: They're making political statements for sure.

S: We were not trying to say that anybody who is questioning, like, how long do we have to do this lockdown while they're struggling financially, that it was somehow political or orchestrated or whatever, so just to clarify that. But we are getting into this transition phase now where we're having a serious conversation, and we do also get some pushback, which I think kind of misses pieces of our conversation about it's not all about just the science of the pandemic itself. We have to balance the effect on the economy because that will kill people too versus the effect of the COVID-19 itself. But here's the thing. No one is saying that we're just going to shut down indefinitely or even err on the side of shutting down. We want to carefully calibrate exactly how to shut down and how and when to open up where. There's good ways to do it and not good ways to do it. And again, I will reinforce, however, that nobody knows ultimately. We haven't been here before. This is the first time we're doing this. I don't think anybody could say that we have a clear map on exactly how to do this. We're feeling our way with just logic and evidence as best as we can, but without really the experience to know what the right thing to do is. So what I'm hearing that I think makes the most sense, and these are, I think, a lot of the recommendations coming from the CDC, et cetera, is that you want to use some kind of metric, like declining numbers of cases, hospital admissions, deaths over a period of time to say, OK, then we could start opening up. You open up gradually and you monitor what effect that's having. If the gradual opening up starts to cause another spike in cases, then you've got to shut down again. And then also continuing to use hand-washing, masks and social distancing while we're opening up. And then finally, we need testing and contact tracing in order to do targeted isolation. Atul Gawande wrote a good article about it because he's at Harvard. He said, listen, we have our process. The process is every day you have to indicate whether or not you're having any symptoms. You get your temperature tested. If you have anything, then you get tested for COVID-19 and you stay away from work until you test negative. If you're positive, then obviously you have it, then you're in isolation for whatever two weeks. So they are being very, very careful. We're doing very similar things at Yale as well. I get my temperature taken every time I walk into my clinic, for example. Everyone is wearing a mask. They're wiping down everything between every patient. We're going to be opening up our clinic next week because Connecticut is opening up. And I just got a big email, here's our protocol, this long, elaborate protocol about how we're going to do social distancing in the clinic, fewer patients, longer times, wiping down between every patient, et cetera. We're going to be doing more, continue to do telehealth for those that we can. It's a process. It's going back to business as usual before the pandemic. I can tell you- That's what we're talking about.

C: You're a clinic. You're a medical facility where you obviously have the know-how, you have access to the tests, you have access to all of the necessary PPE. It's going to take time before a hair salon is able to do this. It can't all just be like everything just opens up on the same day and it's pandemonium. People are going to get sick.

B: Yeah, but I need a haircut.

C: I know, right?

DC: One of the things that I think is going to be sort of a hard truth that we're going to have to accept is that regardless of what we end up doing in the long run until this is over, hindsight is always going to make it look like we did something wrong. There's always going to be families that think that we waited too long to reopen and people that lost their jobs because of it. There will also be people who lost family members that think that we should have kept the controls longer. Those people will exist at the same time. It'll always look like we did something wrong.

C: Yeah. And the sad thing is, we talked about this once on the show, I know, but we've gotten an email since asking if there's a name for this kind of like cognitive bias or this fallacy where basically you look, it's like Y2K, you look at a lack of things being worse and you say, oh look, it wasn't as bad as we thought it was going to be when really it's because of the actions that we're taking are preventing it from being worse.

S: But it's part of hindsight bias. You're looking for information that you didn't have initially, right?

C: But it's almost like it's hard to measure a lack of something, you know what I mean? So it's like people say, oh look, we didn't lose as many lives as we thought we were going to. So obviously we shouldn't have been that worried. And it's like, no, because we were worried, we did all the things we needed to do to prevent that loss of life.

B: Or you could say, or you could say, oh look, the model predicted 2 million dead and we only had 200,000. The models are inaccurate, like no, because you took steps based on the model, so then everything changes.

C: Exactly. Yeah.

S: So the other thing to point out, I think we mentioned this, but just to reinforce it, you know, a lot of economists as well as medical experts are saying opening up the economy to restarting the economy is not the overused metaphor. It's not like flipping on a switch. The whole point is people are not going to necessarily listen to what the government is saying if the government is pushing to open up too early. You have to make people feel safe. Even though it might be legal to go to the hairdresser, people still might not go because they don't want to die for their hairdo. So how do you make people feel confident? You have to actually decrease the numbers. It has to actually work. You can't just, you can't make the choice. You can't choose the economy over the pandemic because if the pandemic is still raging, people are not going to do things. They're not going to go out.

C: Yeah. And that's a big part. Also, the flip side of that is a big part of living in a free society where we have, you know, the right to choose. And we have a lot of these constitutional protections that take care of our privacy and our safety. I mean, I just recently watched a doc about Wuhan and about kind of the early stages in China. And because everybody there is on WeChat, the way that they reopened so quickly is that they have regions in the city that are barricaded with active police enforcement and people have to show a tag in their WeChat. So it's, this is like pure contract tracing. It's kind of amazing. You are either green, yellow, or red because based on your GPS status, they know when you've been within close proximity to somebody who tests positive within a certain period of time. And once that happens, you flip from green to yellow. And once you're yellow, you can't go certain places until you've quarantined for two more weeks. And then, but if you're actively test positive, then you're red. So your movements are affecting other people's movements. And the fact that they have this, like, what we think of as almost like scary black mirror, big brother, but that's how they can actually do such like brilliant tracing and prevent more infection. We don't really have that option in our society. And because of that, a lot of what we're doing is on the honour system.

S: Yeah, that's true. But we can also be done sort of at the workplace level which can be extremely effective. Another sort of significant update in the last week that I wrote about on Neurologica, there were actually four fairly large studies published of hydroxychloroquine as a treatment for COVID-19. And they were all negative. One of them was a actually a prospective controlled randomized trial, wasn't blinded, but it was randomized and controlled. And then the other three were retrospective, but they were large. So there were two, one in New York State, one in a center in New York City both with over 1,400 patients comparing hydroxychloroquine with and without azithromycin versus usual care. No benefit, none whatsoever for any of these four studies. In fact, if anything, there was a little bit of a trend negative, but it wasn't, nothing was statistically significant. But that is important because you can't even say, oh, if a bigger study would have shown a benefit. No, it's actually trending negative. So there wasn't even like a trend to it being helpful. And there was a meta-analysis of all the studies to date, also published. They're publishing like every week, they're updating the meta-analysis of all the published data about hydroxychloroquine. And again, negative. They're basically just no data that...

C: And not just negative, but side effects too, right? Like not just negative.

E: Side effects and depletion of the supply.

S: Yeah. So depletion. So people that like for their lupus are having a harder time getting it. We know that it can cause dangerous heart arrhythmias in the extreme. Although I think that physician... These studies were not like people taking it at home. These were in hospitals.

C: So they're monitored.

S: And in some of the studies, people were stopped. They were taken off the drug because they had EKG changes. So of course, if they were not being monitored, they could have died as a side effect.

E: Sure.

S: It's basically all risk, no benefit is what the data is showing at this point.

C: Well, and the thing is, there is a drug that is showing positive benefits. And so if our world leaders are going to double down on something, it's kind of a weird thing to put his money on, I think, because there actually is an antiviral that so far is showing some positive benefits.

S: Well, I think I know. That's the thing.

C: It's weird.

S: But I said, here's all, it's remdesivir, by the way. Here's what all the politicians were saying. And here's what all the experts were saying. All the experts were like, we have to be cautious. We don't know. We have to study it. You should not take it outside of a controlled setting. Because when politicians put their nickel down, now they have something politically invested in it. And they can't just listen to the science. Now it's a politically, so essentially, whether or not hydroxychloroquine works for COVID-19, it's a 100% scientific question, but it was made into a political question. And that's bad. And now they're doubling down on it and tripling down on it when the evidence is coming back negative. Whereas the experts, they want it to work. Of course, it would be great if we had an effective drug that could save people's lives, get them off the ventilator. It would be huge. But it just, the evidence is negative. You have to call it like we see it.

C: Yeah, when the outcome is life and death, why would you... That's the one time when you can't fall victim to this, like, oh, I'm never wrong. I'm just going to keep pushing. It's like, come on, guys.

J: Well, the conspiracy theories are flying now. I mean, people are actually believing.

B: Oh, God, yes.

J: I actually said this to someone on Facebook, I have to admit.

C: Oh, God, when's he going to learn?

J: Who are they, in quotes? Because it's like, they are making money off of these drugs and we can't trust them. And I'm like, who, the entire medical community? What's your premise here that you're being lied to about what specifically and who is benefiting from this? Because to me, it's so obviously just a rush to, who's the next president going to be? This is about getting elected. All the political nonsense that we're hearing is posturing for the next election. But the medical community-

C: It doesn't even make sense. The arguments don't make sense.

J: Of course not. They never do, Cara. The problem is that in this circumstance, unlike so many other circumstances, people are dying because of decisions that politicians are making. It's so obvious.

C: But it's like, if I were a conspiracy theorist, Jay, I would be like, what is Trump getting out of doubling down so hard on hydroxychloroquine? What's going on behind the scenes with that? And I'm not a conspiracy theorist, so I'm kind of like, I just think he's doubling down on not wanting to be wrong. I think that's all it is. But the truth is, if I were a conspiracy theorist, that would be the thing that I'd be sniffing around. I'm like, come on.

DC: And one of the things is, I think that having worked with people in government offices before, they needed to have an answer of some kind, and they just latched onto the first one. So it happened to be hydroxychloroquine. And then, as Steve mentioned, it's really hard in politics to go back on your initial stance on something. So they put their nickel down, and then they hold it down. And then when they say they need to die, and they say, well, that nickel's fine.

S: That's why you should put your nickel down on whatever the science says.

C: Yeah, that's right.

E: It's always your best bet.

S: It gives you so much flexibility, too, because if the evidence comes out wrong, it's like, well, the evidence is wrong, and I listen to the evidence. It's a get-out-of-jail-free card. But by putting your nickel down on an answer that, before we have it, you're setting yourself up for being wrong.

E: Oh, gosh.

S: And that's what happened.

E: History's replete with examples.

DC: And for better or for worse, we have governors taking up that role where other offices may not be representing as well.

E: Agreed.

C: If you're lucky enough to be in a state with a governor who is taking up that role.

B: Real quick, one other bit of news that came out that was interesting, CDC is now de-emphasizing catching COVID-19 from surfaces and stressing even more it's person-to-person. It seems like it's more of a person-to-person thing, and surfaces is not as involved as they once thought. It's still a risk, but not as a person-to-person.

C: Still wash your hands.

S: Wash your hands. Wear a face mask. Keep your distance.

E: I wouldn't change any of that stuff, right?

J: Watch your kids. Watch your wife.

C: But yeah, you don't have to irradiate your groceries.

E: Go into the decontamination booth I built at home.

S: All right. We're going to try to get through six news items, so let's push forward.

News Items[edit]

Online Symptom Checkers (20:05)[edit]

S: Have you guys ever used an online symptom checker?

J: Sure.

E: No, I haven't.

DC: Seriously. That is a serious...

E: I asked my wife, Jennifer, what's going on because she knows a lot about that stuff.

S: She's your symptom checker?

E: Yeah. She's my symptom checker.

S: So there are a number of them. Some of them are run by things like WebMD or even like the Mayo Clinic. You go in there. You enter your sex, your age, and then they have various ways that you can enter your symptoms from a list or sometimes even just free typing, describing your own symptoms. And then they give you a list of possible diagnoses.

C: And you always end up with cancer.

S: So there's a recent study where they looked at 27 different diagnostic sites, the symptom checkers, and to see how accurate they were. So they had like entered symptoms that were based on a known result, right? They knew what the disease they were going for. They entered the symptoms of that disease. And then they said, what list of diagnoses did the symptom checkers come up with? So I don't know if you guys read my article, but if you haven't, just guess what percentage of the time in the aggregate all on average, all of them together, what percentage of the time did they come up with the correct diagnosis as the top choice versus top three versus top 10?

B: Four foot one.

J: Steve, I read your article and I will still guess incorrectly. But it was extraordinarily low. They are accurate.

C: Top one, top three, top 10?

S: Yeah.

C: 5%, 30%, 60%. That's really low. It might not be that bad.

S: You're a little pessimistic at the low end, but pretty good at the high end. So for the top one, it was 36% got it as the first diagnosis, which is actually not bad, I will say.

C: Good for a robot.

S: Getting the correct, it kind of depends on what diagnosis you put in there, but getting the top one, it's not even that important. It just has to be in the list of things that you're going to work up, right? Top three is kind of important there. It was 52%. And then here's the worst one. Top 10 was 58%. So it didn't improve that much.

C: Oh, no.

S: Yeah. So that's the one that concerned me the most. I read 42% of the time the correct diagnosis was not even in the top 10. That means you missed it. You completely missed it.

C: And were these like common things or were they rare things?

S: Both. It was both.

B: That's a whiff.

E: BEri-beri.

S: I went on a few of these in preparation for my article and I gave myself various neurological diseases that I'm very familiar with, typed in the symptoms just to see how they did. For really common things, like when I said, all right, I have... Well, I said, okay, for one, I'm somebody with a cluster headache and I entered in symptoms of a cluster headache and their first diagnosis was migraine. The second one was cluster.

C: Okay. Yeah.

S: But there's not really much else that has those symptoms. That I was expecting. If it doesn't get this one, it's broken.

E: That was the control, basically.

S: Oh, yeah. Then I gave myself something slightly uncommon, myralgia parastetica, which is basically a pinched nerve in your thigh. Right? Not that big a deal. Total whiff. It wasn't even in the top 10. The first diagnosis was multiple sclerosis, which was not, given that I put my agent, was not even a good guess. That would not be number one on my list if I were coming up with a differential diagnosis. And it completely missed the actual diagnosis. But anyway, that's anecdotal. That kind of fits with what they were saying. I think that these numbers, however, are not surprising for a number of reasons which I'll get into in a second. Perhaps more concerning than that was the triage advice that these sites give. In other words, more important than telling you what you might have is telling you what to do. Like, should you go to the emergency room? Should you make an appointment with your primary care doctor? And there, the triage advice was deemed appropriate only 63% of the time.

C: Oof. That's dangerous. And was it too much or too little? Was it more like false positive triage advice or false negative?

S: Yeah.

C: Because that would be dangerous.

S: Yeah. So it was more false positive. So they were sending a lot of people, they were erring on the side of sending people to the emergency room.

J: So what's the problem, Steve?

C: I guess that's still better.

S: But they did make both kinds of mistakes. It was just they made far more of that kind of mistake.

B: Well, Steve, what kind of systems are they using? Was it some sort of expert system?

S: That's a good question. Every kind because they did 27 different ones. So actually, I'm sorry. Just to correct those numbers, overall, the triage advice was only accurate 49% of the time. It was 63, though, appropriately going to the emergency room and 30 for non-urgent. So it was much less accurate for non-urgent than for urgent care. But overall, it was 49%, so less than half. So Bob, some of the systems use AI and some don't. The ones that do use AI did much better than the ones that didn't.

B: Sure.

S: So that's a good question. So the range was 12% to 61% with the AIs more towards the 61% end of the spectrum. So the authors were pointing out the fact that, first of all, there's zero regulation for these things, right? Anyone could do this, put up their own symptom checker. There's no quality control.

C: Is there a difference, then, between like a Mayo Clinic and like a WebMD?

S: Well, you would expect so, but they're both kind of chumpy, actually, in my experience.

C: Interesting. OK.

S: So it's more whether or not the software itself was more sophisticated. So yeah, you would think that better institutions would have a better application, but that's not necessarily true. So there's a couple of technical variables in here. One is just the sophistication of the software itself, but the other is the information that's put into it. You know, who's maintaining it? Who are the experts that are putting in the data? And is it being kept up?

E: Garbage in, garbage out?

S: Yeah. Is it being kept up to date? So these systems are tricky. So here's the thing. So any clinician, anyone who's in the diagnosis business, knows exactly why these computer programs are doing so poorly, and that's because patients are terrible at communicating information. So one of the caveats when I was testing, it's like, I'm a physician who knows how to describe my symptoms, you know? So I would expect to do a lot better than somebody with the same thing who is not a clinician who is meant to maybe not know what words to use. And I tell you, people confuse words all the time. They call it, they call numbness, weakness, a weakness, numbness, things like that. But not only that patients come to you with a narrative about their own illness, right? They have no idea of what's going on with them about their history. And they give you totally biased information that's filtered through their own narratives that they already have. And that actually affects their memory. We've spoken about this in multiple ways on the show before, like the telescoping memory. And when you think A caused B, you bring them together in time. And they often answer questions relatively, like meaning, I'll say, well, how long have you had that headache? It's since the car accident. They don't tell me, they don't say three years. They've anchored it to an event that may be true. It may completely not be true. They may have decided six months later, maybe it was that accident. And then they remember it as being starting after the accident. So they are anchoring as well. But anyway, you've got to figure out what the patient's narrative of their disease. Then you have to ask them questions in multiple different ways to sort of deconstruct the objective facts from that narrative and then reconstruct it as best you can in a medical way. It's a very dynamic investigative process. And it takes a lot of insight into how people communicate, how they think. And you also have to individualize it throughout your therapeutic relationship with the patient. Trying to do that by typing symptoms into an algorithm, it doesn't work, right? It's just not going to happen. Now, if you have something really basic like carpal tunnel syndrome, then yeah, it should be able to do that. But otherwise, it would be really, really challenging to do it in this sort of dumb way that most of these algorithms do rather than the dynamic way that a clinician does.

C: Steve, do you think it would split somewhere down the middle if it were a lot of my doctors have these things where you can log in to see your test results and stuff. So it's like a secure and it's got your medical records all tied up. So let's say you were logged in and now they have access to your history and all your medical records and then the algorithm utilizes that. You think that that would probably really improve outcomes, right?

S: Yes, it would. Absolutely. A couple other observations here. One is how do people use, why are people using symptom checkers? And I don't know. I'd like to see that data. But I do, what I can tell you is my experience as a physician, because people use me as their symptom checker, right?

C: Guilty.

S: Absolutely. Yeah. That's fine. And that's fine to do that. But what I'm talking about is why are they doing that? And my experience is people fall into three categories. One is just their people just want more information and they don't really have an agenda. They just want more information about something they're experiencing. But often people have one of two agendas. One is they're looking for permission not to go to the emergency room or not to seek medical attention.

C: Yep.

S: You know, they're like, yeah, well, I ran it by Steve and he wasn't too concerned, so I'm not going to do anything, you know. They're basically looking for permission, you know. And then the second group are people who have health anxiety and are looking for stuff to be anxious about. You know what I mean?

C: Yeah.

S: And so like putting in benign symptoms and coming back with multiple sclerosis is not a good thing if you're on the anxious end of the spectrum. And that's something that you also have to figure out in the therapeutic interaction. Like what are people trying to get out of this interaction? And you have to calibrate to the patient. So but the other thing is, what would make this work optimally? You know, what could make it work, just technically work better? Forget about how it's being used. That's a separate question. I think the thing that we would need to do, I think the AI systems is the way to go. But we need to close the loop, meaning that you need to train the system so that you have at some time, there are some subset of patients who are inputting their symptoms. And then at some point, if they get an actual diagnosis, that is then being fed into the system. So it knows if it was accurate or not. Then it becomes like the mechanical Turk. Have you guys played with that? Whereas think of anyone in the universe, fiction or nonfiction. And then with a surprisingly few number of questions, it guesses who you're thinking of. But that's because it gets the feedback. It knows when it's correct and that information gets fed into the algorithm. That could work really well. So then-

C: I'm surprised they're not doing that now. Nobody's really doing that.

S: So it's like, how do patients describe their symptoms when they have this entity? It's also, in medicine, you don't have to guess correct. You just need to have the correct answer somewhere in the top tier of possibilities that are above the line.

B: Top five.

S: Yeah. Whatever. Above the line where you're going to work it up. That's what really matters. And so it's actually easier. You want a differential diagnosis. I often tell this to medical students, what do you think is going on here? But I don't want you to tell me what the diagnosis is. I don't want you to guess the diagnosis. I want you to tell me all possible diagnoses, why you think it's more or less likely and what you think we should do. So that's where we need to get to with this. And this could work as an expert system, meaning providing information to a physician, not providing information to a patient other than triage, which is why I was actually more concerned about that being so inaccurate. So but yeah, I don't know that maybe it's happening out there somewhere. I'm just not aware of it. It wasn't tested in this study.

DC: And the devil's advocate argument to kind of caution against that, or not caution against it, but to be mindful of is in AI, as was mentioned earlier, you kind of have sort of a crap in, crap out. And also, as mentioned earlier, some of these measures are completely subjective. And what that ends up being in AI terms is what, as I understand it, is called a noisy feature. And a noisy feature can sort of make it more difficult to predict what you are trying to predict. So some problems, just because of the data that is provided and how much noise there is in the different features can result in poor predictions in general. And what is, could also, though that's not a nail in the coffin for any particular piece of data. What is a trend in AI going on right now is trying to get away from what's known as black box AI, where you throw in data and it throws out a prediction, and that's it, and you don't get much information out of it. So, multiple AIs and AIs that provide some amount of explanation as to why they predicted things and, or how sure they are, can sort of provide a better sort of operator aid. So, a physician looks at a list of top 10, and then the top choice says, oh, by the way, I'm only about 25% certain at most of all of these things.

S: Well, that's exactly how, that's exactly how diagnoses works, and that's what I, that's what I'm saying. That's what an expert system should be producing. So, what we do in medicine is we have what we call predictive value, right? If a patient clutches their chest with a closed hand, what is the predictive value of that, that they're having a heart attack? We could put a number on that. I don't know off the top of my head what that number is, but that's you could put numbers on things like that. And it's not just test results. It's also how people describe their symptoms or what they do or how they look or whatever, if they have a certain demographic history, et cetera. So there basically would be two ways for the, for an AI diagnostic system like this to work. One would be just in programming it with, with data from research about signs and symptoms and their predictive values, and then the other would be the Mechanical Turk approach. You feed back, if you feed it back the accuracy of the answers that it was previously putting out and then it refines what it does based upon that feedback. And those two things are not mutually exclusive as far as I know. I mean, you could just use them together to make it more powerful. And but for a physician providing expert information, it absolutely has to say why it's saying what it's saying and what the error bars are. Again, remember, it doesn't have to give me an answer. It just has to give me a list of possibilities that I then explore, you know?

C: Yeah. The scary thing is like what you mentioned, it's, it's less about, oh, did I get the diagnosis right? Or is it based on these symptoms? Should I seek medical attention right away? And how do you give that kind of feedback? Like it's one thing to go back and say, hey, it was MS. It's another thing to go back and say, hey, if I hadn't gone in, I would have died. Like how do you quantify that?

S: Yeah. I think it would need to be done in a setting where you have experts who can feed it back the information that it can use to refine its recommendations.

J: So Steve, these programs could most definitely be the cause of people dying.

S: Well, yeah. Before the internet, people would get books at the bookstore that were symptom checkers, you know? So this is not new to the internet. You know, it's got to be this way. You have to be so careful. And that's why I'm very careful. Like when people ask me medical questions, I'm careful, very careful to first of all figure out what their agenda is and to not say anything that they can use in a way to make, to make poor decisions for themselves, you know? By the way, you know who did that to me all the time? Was Perry.

C: In what way?

S: Perry was always looking for permission not to seek medical attention. And the "funniest" example of this, it's like scary funny, he literally calls me up like at midnight one night and it's like, Steve, I can't breathe when I lay down. You know? It's that bad?

E: That's bad.

S: He couldn't breathe. Like the guy couldn't breathe. So I don't need to, like I'll be fine, right? And literally, he literally would have been dead if he didn't go to the emergency room. You know, he would have gone to sleep and woken up dead, right? So I was like, Perry, go to the freaking emergency room right now. And he's like giving me pushback. Why did you call me? You know?

C: Yeah. To hear what he wanted to hear.

S: Because he knew. He knew he needed to go. He knew. But anyway, the real data I want to see is what's the effect of people using these things? And that's the hard real world data to get, but that's what I'd really like to see.

C: Oh, right. Because if somebody...

S: It's hard to infer. It's hard to infer.

C: If it says go to the ER and then they just don't, then there's also that. Like how do you even know?

S: Right. All right. Let's move on.

Crewed Dragon (37:32)[edit]

S: Jay, you have some big news coming up about the crew dragon.

J: You talking to me? I don't have a problem with you. You don't have to give me that attitude. All right. So I don't know about you guys. I have been waiting for this for a very, very long time. So we are, as we record this, we're one week away. So it's going to happen on May 27th that SpaceX will launch their first crewed flight. We're going to have two astronauts, two ASA astronauts, Doug Hurley and Bob Behnken, B-E-H-N-K-E-N. Right, Behnken? And Bob Behnken will be taking the crew dragon space capsule to the ISS. And they'll be riding on top of the Falcon 9 rocket. And this whole thing will launch from NASA's Space Kennedy Center in Florida. You know, just a little interesting fact. This one is for Bob. Bob, when was the last time the U.S. sent a crewed mission into outer space?

B: It was a decade ago.

E: 2010?

J: 2011. Good job. So this new mission is called Demo 2, and its primary function is to test the dragon capsule. They're going to... Now, we've tested it. They've tested the hell out of it.

C: Wait. Then why did they call it Demo? Because it's the last crewed person on something called Demo?

S: Yeah. It's actually not technically even a mission. It's a test.

J: It's a test.

S: It's the last test flight before the first crewed mission, which is later this year, we're hoping for.

C: So wait, does that mean they're going to come back?

J: No, no. They'll go up.

E: It sounded like it's a test flight.

J: Yeah, they'll go up, and they can be anywhere from a month to six months up there. So NASA has paid SpaceX $2.6 billion for six crewed missions using the dragon capsule and Falcon 9. And by the time you hear this, the mission will have already been received and reviewed for flight readiness, which means that they're going through all those last minute checks. The astronauts have already been moved down to the space center. They go through all this rigmarole to the lead up to this, where things are pretty frantic, trying to make sure that all the systems are working, they had to make sure the astronauts aren't sick. But I thought we would take this opportunity to talk about the dragon capsule version 2 and why this is really a landmark situation that we have going here. So first, it's specifically designed to take people and cargo to and from low Earth orbit, and it has a max capacity of seven people. So seven astronauts or seven spacefaring people would be able to go into the capsule. In this particular mission, two people are going, and the capsule will only have a total of four seats for this particular mission that we're talking about. The capsule is considered partially reusable. So it's not as reusable as I initially thought, and I'm not even crystal clear on what the reusability is. I remember reading something that said that after 10 missions, they'd have to do a significant refurbishment. But I think that was hinging on the fact that the capsule would actually do a retro rocket landing, which it will not be doing. This one will definitely be splashing down in the ocean, which does incur more wear and tear on all the components. So I think that they're testing a lot of other systems, and they're not going to be using the landing, the actual powered landing on this one for real significant reasons. And I actually fear that it might not be a feature moving forward, but I'm not 100% sure on that.

S: They've gone back and forth on it for the capsules because, yeah, they said they were going to do it. They said, oh, now it's easier to splash down, but then it's a lot harder to reuse the capsules then.

C: Is it too risky?

J: No, not more risky.

S: No, it's just that the salt water and everything, it's just too expensive to refurbish them.

C: No, no, no. I mean, it's landing.

S: The dry landing. Yeah, the dry landing is just harder to do, you know? And so you either need to perfect the system for a dry landing, or you do the easier water landing. The reason for the dry landing is the reusability of the capsule. So I don't know. I think they're still sort of waffling on that.

J: There is something just so epic about this spaceship having retractable landing gear. It strikes a chord in my science fiction soul. I just love it. I love the imagery. If you haven't seen it, you should look at some of the pictures or video of the testing of the retro rockets and everything. It's really, really cool. So the Dragon capsule has eight 16,000 pound thrust per Super Draco rocket engine, right? So there's eight of those engines. They're grouped in pairs. It has five observation windows, which is really cool. And I know a lot of you guys have seen the inside of the cockpit. The cockpit is freaking amazing. It's mostly touchscreen. There are analogue buttons and a joystick for critical functionality. But most of it is definitely touchscreen. There's a really cool center console. It has a very spacious feel and a futuristic look. I just absolutely think this thing is a work of art. So as of March of 2020, there are four Dragon capsules built right now. There's four of them built. I'm not exactly sure if all four are currently ready to be used. I know, of course, one of them is. But they say that there's four that are built. So they're probably in pre-mission shape because they outfit these things specifically for each mission. So astronauts that fly in the Dragon wear the custom space suit that I'm sure some of you have seen. These are the white ones. They have a completely different look than any other space suit that we've seen. These are specifically made per person, isn't like medium male, medium female. This is Frank's space suit. You know what I mean? And even-

E: Custom.

J: Absolutely. Down to the millimetre.

S: Bespoke.

J: Even though the suits are meant to be worn inside the capsule and they're meant to work inside the capsule, there's a synergy between the suits and the spaceship, that the astronauts could actually have a full vacuum event happen, which is pretty scary. But the space suits can handle that, which is great to know. So they could be in outer space with these suits. I'm sure.

S: That's a real advantage to space suits that they can handle that.

C: Yeah, they can handle space.

S: I like that. I like that in the space suit.

J: Yeah. I mean, you could make it-

B: Especially the hard vacuum.

J: Yeah. The hard vacuum is scary. And that's the thing that you want to avoid, but it can happen, you know? Worse things have happened.

C: Hey, Jay, at the beginning, you said the price tag that NASA was paying for four missions, right?

J: Six missions. Six crewed missions.

C: Six missions. Six crewed missions was how much?

J: It was 2.6 billion.

C: How do you compare to shuttle missions? Like is this cheaper or is it more expensive than the space shuttle was?

S: Oh, this is much cheaper than the space shuttle.

C: The thing you got to keep in mind, Cara, is that I think SpaceX, if I'm correct, SpaceX is coming in as the least expensive of even all the new fleets that are being built. It's very affordable and they have such a wonderful reusability factor in a lot of their components. Hey, Cara, they have 3D printed stuff in these ships. We're talking state of the freaking art. Their technology is fantastic.

C: I don't really think 3D printing is state of the art.

E: 3D prints in space, that's cool.

DC: To put it into some perspective too, in terms of costs for other things in our government, $2.something billion is about the cost of one submarine and the United States has a fleet of 66 of them right now.

E: And how long will the-

C: I love that military spending.

E: And how long will the submarine last for the United States?

DC: Actually quite a long time. They're about 30 year lifespans, so you spend a lot of money on crew. So the initial cost is basically nothing compared to the lifetime of the craft, but something to compare against.

J: That is interesting. Something that is terrestrial could be so much more, phenomenally more expensive than something that's going to go into outer space.

C: Well, it's not terrestrial.

J: It's leaving the earth.

C: It's aquatic.

J: You know what I mean.

C: It's not on land.

J: It's normal conditions, even though it's going very deep. You're not leaving the earth. You're not strapping a rocket to your ass. You are strapping a nuclear reactor to your ass, though. Which would you rather?

C: Yeah. There are a lot of comparisons between going deep into- I mean, it's in many ways just as dangerous, just as unknown, just as whatever.

S: Jay, come on. Have you ever been in a submarine?

J: Well, not the good ones. I haven't been in the modern ones. I've been in the ones that are in museums.

E: I think I toured the Nautilus ones.

DC: It feels like a floating office building that tilts every once in a while. You really can't tell that you're in a craft on the water. The only time that you can tell you're on the water at all is when you're on the surface, and that's where a submarine's basically like a floating hot dog. It doesn't have much stability, so you rock really bad on the surface.

C: But in order to go into one of these, don't you have to be trained, like really trained? You have to know how to do decompression. You have to know how to scuba, right? Deep.

DC: No.

C: You don't?

DC: Ideally, if you are on a submarine, you will never have to swim.

C: No, ideally, you're right, but it's not always like that.

E: Close those screen doors.

DC: I got to do an escape trainer. If your submarine lands on the bottom without imploding, there is an escape procedure, and about a third of people go through that escape training. It's a lot of fun.

C: What? Wait, not everybody-

E: So you're two miles down, and there's an escape plan for that?

DC: Yeah.

C: But not everybody gets trained on it? What happens if you actually have to escape?

DC: Well, then you have the other people there that have been trained to get you along. So there's medical reasons that you can't put everybody through it, and one of them's really funny. It's basically, you're in this suit. It's not like an enclosed suit that's pressurized. So you hook up to this air hose while in this airlock, and then you let all the water in. But the water is at whatever pressure and whatever depth you're at. That then compresses the air that's going into this suit that is not pressure tight. So you are starting to breathe in all this compressed air, and then when you're ready to go up, you open the hatch, you release this, and then the air floods out of this suit. And because it's compressed, it's expanding as you go up. So you basically become this air rocket going straight up. And then while you're going up, because the air is decompressing as you go up, you also have to yell at the top of your lungs the entire time, because you're constantly expelling-

B: Oh, your lungs would explode.

DC: Exactly. And so one thing that they found out while doing this sort of training is that while you're hooked up to this tube, that certain bodily fluids in your nasal cavity will carbonate effectively. And then when you decompress, they will decarbonate and shoot out of your nose all over the inside of the suit.

B: Awesome.

C: Amazing.

DC: So a lot of people don't get to do it because they had a cold in the past couple weeks or something like that.

C: Right.

B: Whoa.

C: That sounds crazy.

J: The truth is, if you go on a submarine, you get great food. They feed you very well, right? Isn't that true?

DC: Yeah.

B: That's what I've heard.

DC: Yes, it is really, really good food. What's cool about the escape training too is the risk of going from, I think it's from like zero to, it's a 15 foot tank, but that 15 feet represents a doubling of the air volume in your lungs. And it's actually the most dangerous part of the traversal. So they keep it, they actually notate it on your record as an actual submarine escape. They don't make any distinction between a real one and a training one because the risks are the same, which is pretty cool.

J: So the only other two things I wanted to say was the Dragon Capsule has an emergency system to, if anything goes wrong during the launch, they can press a button. I don't know if there's an actual button, but it can be called home and the emergency system has been tested and it worked very, very well.

E: I remember that.

C: What does that mean? It can be called home?

E: Well, like a program goes into effect, right, which kind of takes everything over and brings them safely back.

C: How?

J: They could be up 50, 60, 70, 80,000 feet. Something tragic could happen, something the rocket, the Falcon 9 can explode. The capsule has the capability to return back to the earth from that position.

S: Yeah, it separates and deploys its parachutes and comes down. Oh, it just comes back down.

J: Steve, didn't we talk about this? Doesn't it have to fire rockets as well and stuff? Like it has to do something to orient it and get it, yeah.

C: To separate.

J: So that's important. That's important because other previous systems didn't work or weren't even in place. So Crew Dragon also has, and I think this one is like a no-duh, a fully autonomous docking system, which means that the computer can dock it to the ISS. They used to use the arm and the astronauts were flying it in and controlling things. Like why not just have computers do it? So I guess it's more complicated than I understood it to be, but now it can do that. So I'm psyched. This is awesome. This is groundbreaking. We're moving into a new level of technology for spaceflight. And I think most of us alive today will see spaceflight become very commonplace.

S: Yeah. So we'll give an update next week once it actually happens, hopefully.

Robot Boots (50:21)[edit]

S: All right, Bob, tell me about these Roboots or Robot Boots.

E: Hey, what are they all aboot?

B: Robo Boots.

C: Robo Boogie.

B: Yeah. Researchers claim.

S: Shouldn't it be Roboots?

C: Yeah, but that sounds like you're rowing.

B: Robo Boot. I like Robo Boot or Robot Boot. So researchers claim their concept for a novel spring-based, human-powered Robo Boot could hopefully one day allow the fastest people to run 18 meters per second, or for the metric impaired, that's 40 miles an hour.

C: What? No.

B: Yes. This is so cool.

C: How fast are the fastest people now?

E: 24? 25?

B: 12?

C: Miles an hour?

B: 12.3 meters per second. So this is from David Braun, who's Assistant Professor of Mechanical Engineering, and his students at Vanderbilt's Center for Rehabilitation Engineering and Assistive Technology. So this research was also recently published in Science Advances. So for this item, of course, I saw Robo Boot in the title and I was already hooked like a fish. But this was genuinely a really fascinating topic. So human running. The fastest human can run, like I said, a little over 12 meters per second. So how can you dramatically increase that using only human power? Now you might think, well, hey, they got cutting-edge running shoes like Nike's Vaporfly. Have you heard of Nike's Vaporfly? It's a cutting-edge running shoe. It uses 4% less energy than standard running shoes. And actually, there was an Olympic medalist who recently ran, for the first time, a marathon under two hours, and he was wearing them. And that's cool and all, but shoes like this won't dramatically increase running speed ever. They aren't changing the physics of running. They will never match the best way that we've devised to increase running speed. Which way is that, guys? What have we done? What's the best way we create to dramatically increase, essentially, running speed?

C: Meth.

E: Lions, tigers, to chase people.

j: The assist. I've seen the thing where you have like a...

B: I guess it's a little bit of a stretch, but the common bicycle. That's basically what a bicycle is doing. It's making you move your body a lot faster using just purely human power.

C: Bob, that's not running.

B: That's how these researches equate it.

C: No. It's a trick question.

B: They compare it to a way to increase your running speed using nothing, no batteries, no technology. I mean, just something mechanical.

S: But Bob, isn't that because the precursor, they're saying to the modern bike, was a pedal-less bike that you ran on?

C: Really?

S: Yeah.

E: Like Fred Flintstone in his car or something?

S: A wheeled hobby horse. Yes, exactly.

C: I love that.

E: No.

B: The first bike was called a hobby horse. It had no pedals. It had no gears. You could steer it by changing the direction of the front wheel. And the first bike bicycles were four wheels, really. But then the second generation was the two-wheeler. But even that did not increase your running speed. It supported your weight and things like that and helped you out a bit, but you could not go faster than that. You could not go faster than the fastest.

E: But did it require less energy to go the same speed you would have gone?

B: A little bit less energy. But keep in mind, I'm talking about running fast. I don't give a shit about anything else in this content.

E: You brought up bicycles.

B: No, no. I did bring up bicycles, and I did it for a really good reason, because bicycles increase your ability to move faster than anything that's ever been designed that's purely human-powered. So why? Why does a bike do that? Why does it offer that? Here, you're giving metal to a person and saying, here, go faster carrying this, and it works. So some of these are obvious.

J: Because you're overcoming friction to a huge degree, aren't you?

B: To a certain extent. There's three big reasons. The wheels, obviously, are huge. You have a rolling motion with the wheels that prevents what they call collisional energy losses every time your foot impacts the ground. Every time your foot hits, it's jarring. It's friction. It's going to slow you down to a certain extent, and then you push off really fast. So the wheels help. The wheels also support your weight, which is really good, because if the bike is supporting your weight, then your legs can really just focus on moving fast and not supporting the actual body. So that's good. But the big thing, the most important thing about bikes that make them so awesome in making people move so fast is the pedals. It's all about the pedals. Because think about it. They allow you to supply energy continuously instead of intermittently only when your leg is on the ground. So think about that. When you run, every time your leg pushes off the ground, it does nothing for a while, right? It lifts off the ground. You kick off with one foot, it lifts off the ground, and it extends back up a little bit, and then you move it forward and then down until it hits the ground again, and then you push off. But all that time I just described, your leg is dead weight. It's not doing anything for you, and the pedal takes that away. The pedal, it's basically your foot's on the ground pushing all the time, all the time. That's why-

E: Constant on the surface.

B: Right.

E: All the time.

C: That's why you can go farther and faster on an elliptical than when you're running?

E: Probably. It's the same concept, right?

C: You're never taking your foot off. It's basically a large pedal.

B: Right. Right.

C: And of course, there's no impact and blah, blah, blah. But when you add that all together-

B: Right. If you could-

C: It's less energy to go the same speed.

B: Right. As long as you can get rid of that dead time when your feet are in the air, that's what makes the bike so good. The take home is that's why bikes can move you so fast, is because of the pedal. What else can you do besides a bicycle? What about the spring boot? You've all seen these cool spring boots, right? They have a curved piece of metal on the bottom, or some type of bouncy spring mechanism, right? And that increases your ability to leap, and it increases your stride length, and all that stuff. And so you would think, oh, that's got to let you run really, really fast too, or maybe in the future. But those aren't that great either, because that type of foot gear certainly makes it easier and maybe more efficient when you walk, or run, or leap, especially when you leap, because the spring absorbs some of the impact, and then gives some of it back to you, like a kangaroo. So it is helpful for making it a little bit more efficient. But the problem with springs though, and it should be obvious, is that they're still like natural running. You still have a very limited amount of contact time with the ground. And in fact, with the spring boots, you have even less contact time overall with the ground. So you can't even run as fast with the spring boots than a really good runner, a really well-trained runner can. So even spring boots aren't that great.

C: What about those blades that amputees sometimes run on?

B: Same thing. Same exact idea.

C: So they can't run as fast? I always thought they ran faster.

B: No, you can't run. It doesn't necessarily make you faster at running. And then this is what the focus is. Basically, when you ride a bike, your body is somehow tapping into this potential that lets you bike twice as fast as you run. So how can we tap into that potential without a bike? What other mechanism could do this? And this is what the researchers figured out. They wanted to augment running that lets you contribute all the time, just like with the bicycle pedals do. They wanted to have your legs being used to make you move fast as much as possible, not just when your foot hits the ground.

C: Foot bikes.

B: Foot bikes, yes. David Braun. So David Braun worked with his students at the Vanderbilt Center. And this is his quote, which encapsulates how this works. He said, using the RoboBoot, runners supply energy by compressing a spring with each leg while it's in the air. With each footstep, the spring releases its stored energy by pushing against the ground faster and stronger than the legs could otherwise do. So in effect then, your leg would be creating the running energy and storing it in a special variable stiffness spring while your leg is in the air, which would then be released by the spring when your foot hits the ground. So these springs then will offer many advantages of the bike then. The springs could support the body. They could minimize that collision energy as your foot hits the ground. But most importantly, like the pedals, they use leg energy for more than just when it touches the ground. So that's the idea. So going by their calculations, they show that if they could create an ideal RoboBoot, it would allow some people to use their legs 96% of the time, the step time they refer to it, 96% of the step time, to actually run faster than 20 meters per second or 44 miles an hour, which is considered the top speed in cycling. So if you had an idealized version of this RoboBoot, you could run as fast as a top cyclist is what they're saying. But when you try to get more down to earth and more realistic, it's more like 60% of the step time would be utilized. But still, we're talking 18 meters per second, which is essentially 50% faster than Usain Bolt in the 100 meter sprint. You would blow him out of the water, go 50% faster than him using this thing, even if it's only 60% efficient. Remember, this is all just human power. There's no engine, no batteries, no mini fusion engines inside. This is just people power.

E: Is this a concept or is an actual product?

b: Well, that's a good segue into what we can expect to see from this. In the future, they hope to have the first RoboBoot prototype in about a year, which is actually better than five to 10 years. So they have it in a year. And of course, this will be like a version 1.0. But who knows? Over the course of many years, like bicycles have been developing since the 1800s, and they've been increasingly improved, improved, improved over each major change. And I think we could see the same thing for this if this actually pans out. So what could they be used for?

S: Running?

B: The researchers say that this could be used for, yeah, good idea, search and rescue. Who would be running though? Search and rescue, first responders, law enforcement. We may even see, even in sports, imagine there could potentially be an Olympic event that involves this type of thing where people are running crazy fast. Imagine running as fast as a top bicyclist. I mean, that's incredibly fast.

DC: Well, that's the one thing I was thinking about because at least with a bicycle, you have gyroscopic stability. Now I'm running two pogo sticks at 45 miles an hour.

B: Exactly. Yeah, you won't have that. So if you fall, yeah, it's going to hurt. Definitely going to hurt.

C: And can your legs even handle those?

E: That's a good question.

C: I mean, is the difference that you just have a really long stride now, or is it that you're doing the same stride just twice as fast?

B: Well, I mean, I think your stride might be a little bit bigger, but the key is that your body can handle it when you're riding a bike. I think you can handle it using this mechanism. It's not like beyond human...

C: You're sitting on a seat when you're riding a bike though. You're not like...

E: Sometimes.

C: Yeah, I guess that's true. And also a lot of times when people ride bikes, they're not pedaling consistently. They coast in between.

B: That's true. And there are interesting differences. But the key difference with this RoboBoot is that you are generating the energy you need when your leg is in the air. And then as soon as your foot, as soon as the spring hits the ground, blam, you get a huge push off that you could never have gotten with just your legs because your foot's in contact with the ground for just a fraction of a second. So you can't build up a lot of energy that way. A lot of power, I guess, is the more accurate word.

C: I just see a lot of broken ankles and torn ACLs in the future of this device.

DC: Yeah, me too. So I doubt it's going to be as ubiquitous as bicycles, but it will be entertaining to see somebody use it successfully and unsuccessfully.

E: Oh, those YouTube videos will...

B: Well, I think I came up with probably the way this year is going. I have another use for these things. Another potential future use of the RoboBoots could be running away from zombies, especially if they're the fast kind.

C: But here's my thing, Bob. I feel like this has a little bit of a weird purist vibe to it. Isn't something that's powered always going to be better? And I get it if you're talking about just running without technology. But if you're adding technology anyway, is there something more important about it being mechanical and not battery powered? I just don't understand why.

B: Well, then why are bikes still wired? If you don't...

E: It doesn't require a power supply other than...

B: Once you have it, that's it. You don't need anything else. You don't need to...

C: Yeah, but we're not talking about...

B: You don't need to buy fuel. Why are bikes...

C: I don't think this is going to be ubiquitous. We're talking about specialized people using it.

B: Right, exactly.

C: So I'm pretty sure that cops, if there was a difference between a powered boot that was even better and an unpowered boot, that they would just use the powered boot.

B: Well, I think the researchers envision that this would be among the list of many different robot wearables, robotic wearables that could augment human performance. And who knows how this would fit in the ecosystem of powered systems. For sure. Who knows? Can't really predict right now.

E: Here you go, Bob.

B: It's a fascinating idea.

DC: And there's a niche for everything. There's a niche for everything because New York City still has horsebacked policemen despite there being motorcycles and cars. So there may be some niche where...

C: It's just the idea that anybody would say, because it's a horse and it's not a car, it's somehow more important or better. I didn't really understand that because you kept driving home the idea that this is just human powered. It's like, so?

B: I mean, like I said, bikes are just human powered. And also think about the limitation, the biggest limitation of wearable powered systems is what? It's battery technology. And battery technology, slow incremental change. This is something that's always going to be a problem. If you're going to go somewhere and you're going to need to move fast in a human powered way because you're not going to have access to gas or batteries or anything, then this would be something that you would definitely want to do because you don't need anything extra except human power. You don't need gas or whatever.

E: I'm already looking 20 years into the future for this. You've got these for your legs. You build an assembly for your arms as well that will also reach the ground and you can use all four of your limbs to get yourself going on these things. You'll be cheetah speed at that point.

DC: And the face plants will be extra special.

C: Oh yeah, they'll be great.

E: You know, you've got your mouth guard, right?

C: To relearn how to run.

B: I was thinking about that because that's one of the reasons why animals move so fast because they've got double the amount of time where the foot is on the ground helping push off. And that's one of the reasons why they can move so much faster than people because we just have two legs. We've got big forelegs, so four times the amount of surface interaction time, I guess you would call it.

S: Yeah. So it's in the concept stage, not even in the prototype stage, so definitely keep an eye on it. See if anything comes to you.

B: They say a year.

S: Yeah. It's one of those things that we may never hear of again.

B: True. True.

S: But yeah, interesting concepts behind it.

Small Modular Reactors (1:04:59)[edit]

S: David, tell us about, this is a technology I'm actually extremely excited about and it's very disappointing how little support that they get, but tell us about using artificial intelligence to control small modular nuclear reactors.

DC: All right. So this initially started out as me reading a press release about GE, Hitachi, and MIT getting a grant from the Department of Energy through a program called Gemina, which is a sub-program under a broader program called ARPA-E. And the whole goal of these projects is to put investment into the energy infrastructure where there may not be incentive for private industry to do X, Y, or Z. It got started by the Bush administration and has been around ever since. Specifically, GE and MIT got grants to make digital twins of what they call the BWRX-300 reactor design. And that's a boiling water reactor based off of a larger version of it called the Economic Simplified Boiling Water Reactor. And what they want to do in this entire Gemina project is figure out ways to make nuclear energy more cost efficient in terms of an operations and maintenance perspective. So you have this big thermodynamic system. You've got hot, often pressurized water that is moving through metal pipes and going through pumps and going through valves that have mechanical seals and all this stuff. And there's all these things that you have to do to maintain that system, to keep it operational and to keep it safe. Normally, the way that things are done is you kind of just do routine checks. Like every quarter, you go to check the leak by on X, Y, Z, or double check the flow rate or check the resistance across this instrument, stuff like that. GE is going to use what they're calling their Humble AI project, which is AI that is given sort of the constraints of the real world. And there's some way to objectively determine if the AI is behaving predictably or if it's in sort of a context that it wouldn't perform optimally on. And if you detect it in that, it falls back to a more deterministic sort of fallback procedure in terms of maintenance schedules or safety procedures or whatever. It's going back to the whole idea of, at least from my perspective, of trying to peer into the black box of AI. It says that you should do X. Why should I do X? Oh, you're outside of your context. I'm just going to fall back to what we would normally do in this situation. Digital twin technology is them basically making very high accurate models, physical models of this in computer simulation to be able to train these AIs over timescales that couldn't be done in real life or in situations that wouldn't be safely or that you couldn't do safely in real life. I say that this started with me looking at this GE press release. I then backed out and looked at the Greater Gemini project. And there's nine total projects, two of which are kept between GE and MIT. And of those, five of the projects are doing digital twins. And two of them are doing AI or machine learning integration. And then one is doing something really crazy, which is moving away from sort of the normal maintenance concept of install it and then maintain it and do regular maintenance to keep it up. Moving to a model instead where you replace and refurbish something, which is kind of an interesting concept that needs to pan out. But it's very interesting to me because when I was in the nuclear Navy, we didn't have, we had computerized assistance, but for the most part, you still relied on the operator to be able to detect when there was some sort of plant condition that needed some sort of action. Pure automation from a computer standpoint was hard to accept in that industry. Because if your computer was set up wrong, it could go off on a haywire angle. And then if you have one accident, you could ruin the entire nuclear industry. Or in the case of the nuclear Navy, if you have one accident on a nuclear submarine, you could have the entire submarine fleet brought home all in the same day. So it's not desired to have any sort of accidents and to trust or to have your systems trustworthy and to have your people trained to properly operate everything. So I'm really excited about this because AI does have the potential, I believe, to be able to detect things like, say, you're watching the chemistry of your plant because steam systems and primary cooling systems have very tight pH windows because it's hot water moving through metal pipes. And so corrosion gets accelerated like crazy. So maybe this AI will better predict when you need to adjust pH and how often, and that will change through the lifetime of the plant. And as a result, you'll cut costs down while keeping the plant safe. Like that, to me, seems like a reasonable thing. But it's one of those things where it's sort of, you have all the cautions that you normally have with AI models. You have crap in, crap out, and general AI model design. But given the pedigree of the organizations, GE, who's been making nuclear reactors and systems like this for decades, and MIT, who also has a pedigree of nuclear research, I'm really, I'm more excited than cautiously optimistic about all this. So yeah.

C: What's the timeline look like for it?

DC: I'm actually not too sure. The Gemina project did make its formal press release on the 13th. And they do have some white paper releases about that. But I'm not sure about the tenure of these grants. It's $27 million total. Again, GE and MIT got about $6.5 million, if I remember right. Then some general quick facts about small modular reactors.

S: Yeah. I was going to ask your opinion about them in general.

DC: I'm really excited about them. So particularly the Boiling Water Reactor X300, the way that GE designed it was they were trying to cut costs down. So this ESBWR that they had done has all these parts and components that have already been through the NRC sort of regulatory structure. So the control rod mechanisms, the pumps certain valves, all that stuff have already been certified. So they're basically reusing those because they already know they work. They're reducing some of the costs by switching to a metal containment versus a concrete containment. And they're shrinking it down. So these things take up 90% less space. It's 300 megawatts in 10% of the space of 1.5 gigawatts.

E: Jay?

J: No, I mean, there isn't a geek alive that won't laugh when they hear that.

DC: And then they're designed to utilize what's called passive safety. In fact, the IAEA has a small modular reactor book that you can download that has 50 of these designs. And if you control F for the little part of the Excel sheet that says like what safety systems they use, pretty much every single one of them use passive safety. And that means literally every operator could walk out of the room and the reactor would either shut itself down or operate safely agnostic to operator error. So in particular, the boiler water reactor design is natural circulation driven. So there's no forced circulation. There's no pumps needed to operate the reactor.

S: So Homer Simpson could work at this reactor is what you're saying.

DC: Yes, absolutely. Absolutely. And again, it's like it's 300 megawatts in 10% of the space. It's also much cheaper. They're trying to get under a particular capital cost bar that makes them competitive with natural gas. And then they're trying to get, again, under a cost per kilowatt hour operational to compete with natural gas as well as other renewables. But if this all excites you, you should definitely still get in touch with your congressman because this overall project, ARPA-E, they have a line by line budget that's put out by the Department of Energy. And while there is money being allocated to this kind of research, overall funding for these sort of researches into grid technology have been cut and disproportionately away from renewables and nuclear. If you have time and you're excited about this kind of research, please take some time and write your congressman about that kind of thing because these small modular reactors are really cool and could really innovate the nuclear field.

E: And what's the byproduct?

DC:The byproduct?

S: You mean waste?

E: Yeah, waste. I'm sorry.

DC: That's actually something that I got excited about. I saw $90 million allocated to nuclear waste handling in the most recent Department of Energy budget request, which was kind of exciting, but it will produce some amount of waste. I'm not pretty clear on the details. Some reactors have waste that can be reprocessed and reused, especially the ones that were designed to develop plutonium and produce a lot of waste, but that waste could be used by other reactor designs. There's a whole separate conversation about that that could take for quite a bit of time.

S: Yeah, yeah. Just very, very quick. I've been reading a lot about that as well. There are cycles that they're experimenting with, nuclear cycles, where basically, again, there's no difference between nuclear waste and nuclear fuel. That's a relative designation. The only difference is what we can burn, right? If you can burn it, it's fuel. If you can't, it's waste. It all depends on what we can do. These newer reactors are definitely able to burn more thoroughly through the fuel and leave less waste. With reprocessing, they have reprocessing cycles, at least on paper now, that can take all of the long-term products, ones that take a million years, half-life, and get rid of them, basically, and burn them so that you're left with only the ones that last for hundreds of years, not millions of years. It's a complete game-changer in terms of nuclear waste, but we got to do it. We just got to do it.

DC: Yep. To give you some perspective, as I mentioned before, we have 66 submarines by my last lookup active in the US Navy. Those submarines have reactors that are on the order of 200-some megawatts. We have 66 of those all around the world. I don't know how many civilian plants are still operational, but as I understand it, I think it's less than the number of military-deployed ones. The military-deployed ones we send to other countries, sometimes friendly, sometimes not friendly, and we let them tool around, not necessarily saying that we're there. We're comfortable with that at the government level, and I think we could be more comfortable with that in our own backyard if we're willing to put a nuclear reactor in, say, an ally's port.

Who's That Noisy? (1:16:55)[edit]

  • Answer to last week’s Noisy: Pet Fox Steals Phone[6]

J: All right, Jay, it's, who's that noisy time.

J: All right, last week I played this noisy.

[Cackling animal has taken someone's phone]

All right, so I got like so many responses. It was really fun. This one, so many people got right, just like last week. I definitely need to turn up the difficulty starting after this one. So guys, do any of you have a guess before I go into the emails?

E: It sounds like a dog took someone's phone and ran away with it.

C: It sounds like an animal. I don't know if it was a dog.

E: It was recorded. There's a painting of an animal or something.

C: Yeah, it could have been a fox.

DC: I want to guess. Yeah, the chortling makes it sound like it's a fox.

J: Well, a listener named Dan B guessed, that sounds like a monkey that took off with a kid's smartphone.

E: Monkey phone.

J: Yeah, so you're in the right phylum, but that is not correct. Sarah Nash wrote in, Jay, hi, I am Maggie, age 11. I love your show. I think the noisy from last podcast was a dog named Daisy who was running from their owner with their phone in its mouth. While their owner yelled, Daisy, don't eat my phone. Don't you hurt my dog. Maggie, that is not correct, but thank you for writing in. You're closer. This thing is definitely more like a dog than it is like a monkey. So the winner from last week, the winner is Bill Woolverton. Bill said, pet fox steals girl's iPhone while it's recording and runs away from girl with it. That's what he wrote.

C: It's a pet because she's named.

E: Pet fox?

C: Is it a Russian fox?

E: Oh, then we can talk about Russian foxes.

C: Yay. That's so cool. Yeah. They promote to keep the best pets.

J: So the founder of Save a Fox Rescue set her phone on the ground against a barrel to film a yoga video and her pet fox took the phone in its mouth and ran away. Now you can hear Dixie the fox laughing, literally laughing at her. Listen to this. [plays Noisy]

B: What?

J: He's excited. The fox, or she's excited. The fox is definitely excited and knew that it was doing something naughty, which is adorable. And this fox is trained and raised and all that. But it's still a wild animal. They're not domesticated.

C: Well, they are if this is from the Russian foxes. I wouldn't say that.

J: You come with foxes.

C: It might not be, but a lot of, "pet foxes" do come from that experiment.

S: Yeah. Don't they cost like 20 grand or something?

C: They're expensive, and they pee themselves constantly because they're so excited to have people that they can't control it.

S: So did my puppy. I had a miniature, long-haired dachshund.

B: Murray! I miss Murray.

S: Took three years to potty train, and then even then had happy pee whenever he got excited.

C: Yeah, that's the thing.

B: Especially when he saw me.

C: Yeah, some dogs have that. Apparently, the vast majority of the Russian foxes have that, because it's just one of those things that, because it was a forced evolution, it's close enough to the gene or the alleles that it's what, I guess, very domestic animals do. They're just too excited.

J: That's nutty. So that was sent, the original Who's That Noisy was sent in by Christina Lynn. So, Christina, thank you. This was a lot of fun. The fox is adorable, and thus ends my adorable animal series. I had a mini adorable animal series.

New Noisy (1:20:44)[edit]

J: I have a new noisy for you guys this week. This was a noisy that was sent in by a listener named Damian Van Schneidel. God, Damian, don't be mad. Yeah, if I don't say your last name correctly. This one is really cool. So, this is one of those noisies. I'm warning you right now. It's a little sharp. You might call it loud.

S: It's a little harsh.

J: Yeah, it's a little harsh. Throttle back. Ready? And here we go.

[brief, vague description of Noisy]

All right, so before the jokes come out, I'll say my own joke. That's the noise that happens before I fart in the house. There you go. So what I'd like you to do is, with as much information as you can, tell me what's happening in this sound. What is this associated with? What's happening? What's going on? And please email me at if you heard something cool this week or if you think you know the answer.

Announcements (1:21:45)[edit]

J: And Steve, did you know, Steve, that there's multiple things going on all at the same time around the world?

S: Sure.

J: Right? So one of those things is NECSS, We're doing a live streaming conference this year because, oh the pandemic came to town, came everywhere, and we did not want to not have NECSS, so we decided to do a live stream. The list of speakers is almost complete. I will begin the marketing probably tomorrow. It will be on Facebook and other social media if you're interested, and I will give a full announcement next week of everything. We're doing great. I had a technology meeting with Ian today. The green screen is working, and everything is looking good.

S: That's good to know.

J: Yes. Things are good. We really know what we're doing this time. Oh, boy. They said it.

C: This time.

E: The green screen is green.

S: I hope you're not setting us up there, Jay. All right. We're going to do one quick email.

Questions/Emails/Corrections/Follow-ups (1:22:45)[edit]

Email #1: V.A. Shiva Ayyadurai misinformation[edit]

Could you PLEASE talk about this MIT Ph.D. that has been spreading misinformation about COVID?! This is the description to his latest FB live: "Dr. Shiva LIVE: Hydroxychloroquine - How It Works, Benefits and Side Effects. Dr. Shiva Ayyadurai, MIT PhD in Biological Engineering, the Inventor of Email, world-renowned Systems Biologist, Innovator, Scientist will share the molecular systems biology of Hydroxycholorquine on how it works, its benefits and side effects." He also claims he invented email! - Gary W. Candido

S: This one comes from Gary Candido. Gary writes, "Could you please talk about this MIT PhD that has been spreading misinformation about COVID? This is the description to his latest Facebook live. Dr. Shiva live, hydroxychloroquine, how it works, benefits, and side effects. Dr. Shiva Ayyadurai, MIT PhD in biological engineering, the inventor of email, world-renowned systems biologist, innovator, scientist, will share the molecular systems biology of hydroxychloroquine on how it works, its benefits, and side effects." Right. This guy claims-

C: Wait, what? He invented email?

S: That he invented email. I had to check that claim out. What do you guys think? Do you guys know that Dr-

DC: Low probability of that.

E: I would say not any one. How do you nail it down to one person?

B: Tell me the name again, Steve.

E: An organization?

J: It just reminds me of Dr. Evil saying his father invented the question mark.

S: Dr. Shiva Ayyadurai. It's BS, right? It's totally BS. He claims that when he was 14, in 1978, he invented email. He wrote a email messaging system that was email.

C: Wait, what?

S: He did do that. When he was 14, he did write an email program, but he didn't invent email. Email predated that. It goes back to the 1960s. It's very well documented. The history of email is all there. The person who is most credited with it is Ray Tomlinson, who came up with the at symbol, the idea that you have a person at a location. You know what I mean? All the elements that make up email were all in place by 1975 before this guy Shiva wrote his program in 1978. He didn't invent email. He actually sued TechDirt for pointing out that that's not true, that he did not invent email, and he lost that lawsuit.

B: How did he lose it? How did he lose it?

S: What do you mean, how did he lose it? Because he didn't freaking invent email.

B: Can you see that case? The judge is like, oh, wait, let me check. Let me Google it. Oh, no, you didn't invent it. You lose.

S: Right. That's basically it. You can't prove that what they're saying is wrong, basically. The judge didn't say you didn't invent email. He just said, you can't prove that what these people saying that you didn't invent email are wrong. That's kind of all they had to do. And whatever. It was their free speech and everything. Yeah, just ridiculous. So right there, his credibility is in the toilet, right? If you're claiming you invented email when you didn't, it's just ridiculous. But I watched this video that he's talking about, and he's just going over the potential molecular mechanisms of hydroxychloroquine, which here's the thing. This is like the typical basic science researcher mistake, is that they think because they understand something at a basic level, they could make clinical claims about it. And you can't, because how it might work on a biological systems perspective doesn't tell you if it actually works clinically. You need clinical evidence to tell you that. And the clinical evidence is negative. So this guy is like a Dunning-Kruger, all over the place. This is what happens when you have, this is where we talk about the Nobel Prize syndrome. If you have credentials in one area, and then your ego is just unchained, right?

B: Yeah, Linus Pauling.

S: Yeah, Linus Pauling is a good example. And so of course, I get most annoyed when the non-clinicians make clinical claims based upon their non-clinical knowledge, and they always embarrass themselves like this guy is, because they have no idea how to evaluate clinical evidence, because it's different. I don't care if we have some data about a potential mechanism. All it does is make it plausible. It means that we should study it clinically, which is what all the experts, including myself, were saying about it months ago. It's like, yeah, it's plausible. We should test it. It's been tested. It turns out, at least the evidence we have so far is really negative, which means it's very unlikely that there's a significant clinical effect that's being missed by this preliminary evidence. But he doesn't know how to think about the clinical evidence, because that's not his expertise. But yeah, the whole inventing email thing is like the icing on the cake. All right, let's move on to science or fiction.

Science or Fiction (1:27:18)[edit]

Answer Item
Fiction Baker's dozen
Science Presliced ban
Dyed brown
Host Result
Steve win
Rogue Guess
Dyed brown
Dyed brown
Dyed brown
Baker's dozen
Baker's dozen

Voice-over: It's time for Science or Fiction.

Theme: Bread
Item #1: The U.S. Government banned presliced bread in 1943, but the ban lasted only several months due to widespread protest.[7]
Item #2: In the U.S., some products sold as wheat bread are just white bread dyed brown with caramel coloring.[8]
Item #3: A "baker's dozen" is 13, originally used as a marketing ploy, as 13 is prime and cannot be easily divided, encouraging purchase of the full "dozen."[9]

S: Each week I come up with three science news items or facts, two real and one fake, and then I challenge my panel of skeptics to tell me which one is the fake. We have a theme this week. The theme is based upon my latest pandemic hobby, baking bread.

C: Oh, God.

S: It's all about bread. Come on, you guys eat bread?

E: We love bread. Oh, my gosh.

C: I have had it.

S: Yeah, you've had bread.

DC: I've ate it once, so I'm an expert about it.

C: Exactly.

B: You've had it with these questions, Cara?

C: I have.

S: So I made another loaf of the sourdough. It tasted great. It didn't really... It was kind of flat because I didn't have the right kind of pot to put it in. And then I made...

C: Yeah, that's why.

S: No, it's true. It rose nicely. It was very fluffy, but it just was... Because it's soft, the sourdough is very wet, so it will flatten out like a pancake if you don't keep it in a Dutch oven, which I don't have. So anyway...

C: Well, you've got to get a Dutch oven. They're the best.

S: I know. I know. I need to get one. So today I made just regular Italian bread using yeast. God, it's so much easier.

C: And honestly, it's in some ways more useful, although you can do a lot with sourdough starter. Sourdough is a very particular taste.

S: Yeah, which I like, and it was very... It tasted great. The bread I baked today came out really good. We had one of the two loaves for dinner. It was great. But...

J: So you made Italian bread. I mean, how good did it come out?

S: It was great. It was perfect. It tasted like any Italian bread you've ever had. But the thing is, though, the crust was pale. It didn't turn this golden brown. So now I'm troubleshooting how to fix that. And I've read some things... I didn't wash the top of it with anything. And sometimes I could put water on it, or milk, or yeah, whatever, to make it that little brown. So next time I'll... Yeah, egg. So those are the three I read about, water, milk, or egg. And they said, it depends on what you want, et cetera, et cetera. But next time I'll try it with a wash and see if I can get the outside to look a little bit more golden brown. So we'll see.

C: Oh yeah, it'll be beautiful.

S: It's a whole technology skill set unto itself. So you just have to really just do it and figure it out as you go along.

C: Baking is science. It's like basic lab science.

E: Oh, food science? Are you kidding?

C: But baking specifically, it's like a lot of the same skills that you learn when you're learning to do wet lab work.

S: Mm-hmm. Yeah. And the thing is, I follow recipes no problem, but this is more than following a recipe because there are some skills involved with it as well. A lot of it is, I think, the experience of doing it. Anyway, so for all of those reasons, we're talking about bread. So are you guys ready to hear the three items?

J: Let's do it.

C: Yep.

S: All right. Number one, the U.S. government banned pre-sliced bread in 1943, but the ban lasted only several months due to widespread protest. Item number two, in the U.S., some products sold as wheat bread are just white bread dyed brown with caramel colouring. And item number three, a baker's dozen is 13 originally as a marketing ploy, as 13 is prime and cannot be easily divided, encouraging purchase of the full dozen. All right, David, as our guest, you have the distinct honour of going coveted first position.

David's Response[edit]

DC: It is indeed an honour, and I will try to do my best based on all the times I critiqued you from my armchair doing poorly. So the first item about the U.S. government banning pre-sliced bread in 1943, but it obviously not lasting long because that's super convenient. That seems plausible just because I'm kind of curious as to whether or not the U.S. government did it at a federal level or a state level or something like that, and I can easily see like some...

S: No, I'll just clarify that. I'll clarify that it was the federal government, that the U.S. Federal government.

DC: Yeah, it's the federal government. And that's around World War II era, so maybe it was a rationing thing and the fact that it was sliced as sort of an arbitrary metric, who knows. Going on to some products sold as wheat bread are just white bread dyed brown with caramel colouring. That sounds compelling because of standard narratives about how obviously somebody is doing that, but who knows. And then a baker 13 originally as a marketing ploy as 13 is prime number and cannot easily divide, encouraging more consumption. I believe that more because it seems like somebody or something that would happen upon accidentally and then would turn into a marketing strategy where somebody started selling a baker's dozen, noticed that they were selling more volume, and then they sort of worked backwards and figured out the process. I'm going to go with number two just because as being the fiction because I think the USDA or somebody else has some specific rules about what can and can't be called 'wheat bread", and that you can't depart from those without potentially getting in trouble with them. So number two, or sorry, the wheat bread that's just dyed that way, I believe is the fiction.

S: Okay, Bob.

Bob's Response[edit]

B: Let's see. The pre-sliced bread makes sense that that could just be a money-saving during World War II. Number three, the baker's dozen. Yeah, I can go either way with this one. I could make sense at a lot of different angles. But yeah, I'm going to agree and say that number two, that the wheat bread, yeah, at first I was thinking that's exactly what those scumbags would do because there's so much false advertising and that kind of stuff. Even whole wheat, it isn't necessarily as helpful as you think it is. And they are strict. I think they're very strict. I don't think you could say wheat bread if it's just white with a little dye. I think there might be something critical that would need to be beyond just the caramel colouring. So I'll say that's fiction as well.

S: All righty, Evan?

Evan's Response[edit]

E: Well, for a lot of the same reasons already expressed, I'm going to join the guys and agree that the wheat bread one is the fiction. I don't think you can get away with calling something wheat bread unless there's actually some percentage of wheat in there. And yeah, 1943, about that one, banning it. Yep, World War II, right in the middle of it, there were all sorts of rules about rationing and what you can and can't do. So that I can't – easy to believe that that's part of that. And then the baker's dozen marketing ploy, yes, I absolutely believe that that's right. So I'm with the guys so far.

S: All righty, Jay?

Jay's Response[edit]

J: Am I the last one? No, Cara's going to be last.

C: You forgot I exist. Thanks, Jay.

J: I don't know. Sometimes Bob sounds like you. All right, so the sliced bread ban during the war, I believe that is science. I have a little trickle in the back of my head of what the reasoning was. I'll move on. Oh, my God. The next one here, yeah, the wheat bread being sold as actually healthy bread that has a lot of fibre in it and whatnot, I completely think that one is science, that that is the truth. You would be amazed at what we can be lied to about with the labeling and marketing. They call it wheat bread. Well, what does that actually mean? What the freak does wheat bread actually mean? So it all comes down to what the rules are and what they can get away with. So I think that is science. I absolutely do not think that a baker's dozen had anything to do with as a marketing ploy here. And if the 13 is a prime and cannot be easily divided, nope, I don't believe that this one is a fiction.

S: Okay, so Jay's going to break from the group. Interesting. All right, Cara, you're last.

Cara's Response[edit]

C: I'm with Jay. Then that's exactly what I was thinking. I think that wheat bread just in and of itself, I would not be surprised if this is bleached flour that then is re-dyed to look like it wasn't bleached flour. And I don't think wheat means anything. It's not a regulated term. The bread ban one, I still don't get. So I'm excited to hear the story, but it seems like it could have happened. I don't know if it had something to do with the war or rationing, or if it was more likely like the extra step of slicing it, there was some sort of like outbreak, like somebody got sick or something. So they thought, okay, if we ban slicing it, people won't get sick. I don't know. But yeah, maybe it's just easier for people. So they got mad about that. I can't believe there'd be widespread protests, but that's hilarious. But I guess it's true. And then the baker's dozen one, I guess the wives' tale that I always thought was that if there's just like extra that you can't make into another pack of 12, that bakers would throw them in as a bonus or something like that. And that's where it came from. It's probably not any of these things. But I feel like your explanation as a marketing ploy specifically with it being prime is like too specific. So I bet you it's something different. So I'm going with Jay.

Steve Explains Item #1[edit]

S: All righty. So let's start with number one, since that's when you all agree with the US government banned pre sliced bread in 1943. But the ban lasted only several months due to widespread protest. You guys all think this one is science. And this one is science.

J: Steve, can I take a guess?

S: Yes.

E: Again?

S: Why they were banned?

J: You know, Steve I love-

C: That was not passive aggressive at all.

J: You know, I love bread.

S: Yes, I do.

J: And I've come to realize that in these certain pockets, I have-

E: Bread pockets.

J: I have good knowledge on certain things in certain pockets. Does this have to do with the wrapper on the bread and not the bread itself?

S: You're correct.

B: Oh, what the hell.

S: So they're actually-

C: They had to wrap it, right.

S: All right. You're correct, J. So sliced bread started around 1928, pre sliced bread. And it was a, again, it was a great thing. That's where the term that's the greatest thing since sliced bread comes from. Because it was a huge time saver.

J: It was a hit. It was a hit.

S: It was absolute hit. And it became within a couple of years, 80% of bread sold on the market was pre sliced. It was just really popular. But some somebody, and it's hard to know who, because it was so unpopular that nobody would take credit for it, that the federal government decided to ban it. It was a World War II thing. I told you, so David, you were correct to key in on that. So they were experimenting with a lot of things in World War II. And so the paraffin and the wax wrapping around bread, you need about twice as much for sliced bread as for not sliced bread to keep the sliced bread from drying out.

C: Oh, right. Because this wasn't like plastic era.

S: Yeah, it was paraffin wrapping paper. And so they wanted to save paraffin by banning the sliced bread so that you could use less of it. It actually didn't even work. Even for that thing, it didn't work. But they didn't save, it saved very, very little paraffin. But also the idea was that they wanted the baker, bakeries to not raise their prices. And so it was a ploy to keep the price of bread down. So that, because that was regulated, but they were sort of charging a vig for the slicing and they wanted to get rid of that so that the price would be kept down. But actually it didn't really work there either. The thing that probably ended it was a letter to the editor of the New York Times on January 26th. This was from Sue Forrester of Fairfield, Connecticut.

E: Yeah, Sue.

S: And she was complaining on the behalf of the country's housewives. So that was the sign of the times there, Cara. And she basically was like, do you know how much freaking time I waste every day slicing bread? Are you kidding me? Plus, you know how hard it is to get a good bread knife in the middle of this war which was a legit point that no one had thought of.

E: Yeah, metal was precious.

S: So yeah, it only lasted a few months. It was so, it was massively unpopular. They got rid of it and nobody could even, would take credit for even doing it in the first place.

C: Wasn't me!

Steve Explains Item #2[edit]

S: Let's move to number two. In the US, some products sold as wheat bread are just white bread dyed brown with caramel colouring. So Jay and Cara think this one is science that, yep, some companies actually do that. The rest of the guys think that their regulations would have to keep companies from doing this. And this one is science.

B: I knew it.

S: Good job, Jay and Cara.

C: Yeah.

S: Yeah. So the key word that's missing there, and this is all true, they do it. They dye the flour brown with caramel colouring.

J: Is it whole wheat, Steve?

S: It's whole wheat.

C: Whole wheat. Yeah.

DC: That's the regulated term.

S: It's got to be in the, it's actually, you really, you have to look at the, every reference I said, you have to look at the ingredients. So if it's, in the first couple of ingredients, it needs to be some whole grain. And it has to say whole wheat or whole whatever the grain is, that is whole oat or rye or whatever. If it doesn't say that in the first, okay, if it's too far down, that means they threw a little bit in there. It's got to be one of the top ingredients. Then you're not really getting whole wheat bread or whole grain bread.

J: So if you ever see, if it says country bread or honey bread, that's bullshit. That is not, and the reason why I know this is because since my wife and I got together, she really got me to read food labels. Because she wants to, she wanted me to avoid what do you call it?

S: Trans fats and shit.

J: Trans fats. And you could, and you would be amazed in what foods, it's actually like, I think the list is going down a little bit now because food companies are starting to-

C: Aren't trans fats banned?

J: Yeah.

S: Some places, yeah.

J: But so, but it's still, now I'm like after doing this for so long, I'm just like, I inherently do it. And I noticed like, man, there's no difference between this loaf of bread and Wonder Bread. There's no difference.

C: Yeah. It's pretty amazing. Sometimes you check like a cereal brand that's like health-oriented and you're like, this has the same amount of sugar as Lucky Charms.

S: Exactly. Exactly. It's all marketing. It's all marketing. So yeah, be to watch out for that. But there are some breads out there that are whole grains. I like the whole grain breads myself.

C: I'm sure it tastes better.

J: Once you make the switch, once you switch over, it tastes so much better. It's just a better bread.

S: It does. Yeah. I like whole wheat, everything. I like wheat, pasta, whole I like it all.

J: Now you've gone too far my friend.

S: But it's good. It's hearty. It's hearty.

C: No, it's got more of a depth of flavor. I agree.

S: Yeah, absolutely.

DC: I still love Wonder Bread nostalgia trips every once in a while though.

S: I mean, white bread's fine. I remember sometimes seeing like the brown bread and thinking, God, this is not freaking whole grain bread. This is it's brown, but what is this? This is like white bread.

J: Steve, can I guess the last one? Because this is the one I really think I know.

S: Yes. But let me read it.

Steve Explains Item #3[edit]

S: A baker's dozen is 13. Originally, as a marketing employee, 13 is prime. It cannot be easily divided. Encouraging purchase of the full dozen. That is fiction. I completely made that up. So what is the real reason, Jay?

J: So this has everything to do with medieval bakers not wanting to break the law or get in trouble because there was something about like the loaf size. You know how like today when you go buy a box of cereal and you're like, did I get bigger or did this cereal box actually get smaller? Right? You ever have that happen to you? Cereal boxes are thinner. They're thinner today than they were. So they're ripping you off by-

E: You get less product.

J: Yeah, less product. About 20% less product for the same price. So this is what was happening back then is that bakers were making loaves of bread smaller and then saying, here's a dozen loaves of bread. And it's like, yeah, but this is the equivalent of three loaves of bread. You know what I mean? So what they would do is they would give you 13 loaves of bread instead of 12 saying, I'm giving you an extra loaf of bread just to make sure that they're giving you enough bread so they don't get in trouble. Is that correct?

S: So you're close. Yeah. So it was in medieval England when this rule came out. And essentially, to prevent bakers from shortchanging their customers, they were statutes that regulated the weight of the bread being sold. So if a dozen rolls or a dozen loaves had to weigh a certain amount, and if it weighed less than that, you could be fined. But of course, there's variability in exactly how big and how much things weigh.

C: Did they have scales in medieval? Was every baker using a scale?

S: They had scales. They had scales.

C: Seems like it would be expensive.

DC: Did it weigh as much as a duck?

C: Yeah, exactly. That's what I was thinking. It was like a standard.

S: If you threw in an extra whatever loaf or roll, that was a hedge against coming in just under the weight. So that's a way for the baker to make sure they don't get fined because they're over the weight of a dozen because they threw in an extra in case a couple of their loaves were a little light. And it's not necessarily 13. It could be 14. It could be 15, although usually, it's 13.

J: Well, like sliced bread, people took that really seriously. It was a big deal. Because today, for most people, a couple of slices of bread out of a loaf is not that big of a deal. I complain about cereal.

S: Oh, that was life. That was the big deal. Apparently, this started with in 1266, Henry III revived an ancient statute regulating the price of bread. So that's where it goes back to.

J: Now, how cool is that? This idea of a baker's dozen lasted. It's in our, what do you call it, Steve? The unconscious-

S: Vernacular. It's like almost 800 years later. It's still there. There were some other cool things when I was researching this. So you know the word for lord and lady mean bread? So a lord was like the bread ward, and the lady was the bread maker. That's what those words derive from in Old English. Yeah.

C: Wait, so she made the bread, and he just like-

S: Her servants made the bread, and he distributed the bread.

J: Steve, you want to know, you want to hear something that's even cooler than that?

S: Yeah.

J: Cara and I won this week. Cara, high five.

S: You did.

C: Hells yeah. Woo-hoo!

S: Good job, guys. All right, Evan, give us a quote.

Skeptical Quote of the Week (1:46:10)[edit]

Mathematical science shows what is. It is the language of unseen relations between things. But to use and apply that language, we must be able fully to appreciate, to feel, to seize the unseen, the unconscious.
Ada Lovelace (1815-1852), English mathematician and writer, chiefly known for her work on Charles Babbage's proposed mechanical general-purpose computer, the Analytical Engine.

E: So before I give you the quote, I just wanted to give a little shout out because I was featured on another podcast called the TWA Family Hour Podcast. TWA stands for The Word Alive. The Word Alive is a band, a metalcore band, one of my daughter Rachel's favorite bands. We went to see them. They performed in New Haven. This was back pre-COVID, just before it all happened. And as part of the experience, we got a meet and greet with them, which turned out to be a podcast. They started this podcast just recently, just shortly after that. It turned into Skeptics Guide meets metal music kind of show. And they did a really nice thing in which they have titled the episode in New Haven, Connecticut with Evan from the Skeptics Guide to the Universe.

C: Aw.

E: That was very nice of them to promote that for us. Thank you. We will promote you, our friends at The Word Alive, Zach, Tony, Telly, and Matt. Thank you so much. And you should check them out as well, The Word Alive and the TWA Family Hour Podcast. And now the quote. "Mathematical science shows what is. It is the language of unseen relations between things. But to use and apply that language, we must be able to fully appreciate, to feel, to seize the unseen, the unconscious." And that was written by Ada Lovelace.

S: One of our forgotten superheroes.

E: Yeah, definitely. We're talking her. She was born in 1850 and died in 1852. Was an English mathematician and writer. She was chiefly known for her work on Charles Babbage's proposed mechanical general purpose computer, the analytical engine. She's widely regarded as the first to recognize the full potential of computers and one of the first computer programmers. So cool.

S: That is amazing. You know, you think about it, there was something like a computer in the 1800s.

E: Right. Just even the idea of a computer in the 1800s. I mean, beyond an abacus is just remarkable.

C: And also that a woman was the one who, like in a time when women could do very little in society that were "man's roles". I mean, that's like a really, really big deal.

B: Right. And beyond that, what always impressed me is that she saw the implications of what the technology could potentially accomplish before pretty much everybody.

S: I'd love to bring her to the modern day and have her see what has become of Babbage's new machines.

B: I knew it! I knew it!

E: What would she do? Yes, in the 21st century. Oh my gosh. She'd be so happy and she would blossom even more.

J: Hey David, I want to thank you so much for being a patron of the SGU. We really appreciate it.

DC: Yeah, it's definitely an honour to come on the show. If I can, real quick, I'll give a quick shout out to a couple of my skeptical heroes. My mom and dad. My dad mainly because he got me skeptical by telling me that I wouldn't be able to drive until I was 35. My husband, Mikey Campion, who's love him to death. And one of my favorite professors, Liz Bradley, over at the University of Colorado Boulder. Really, really great professor in the computer science department out there.

S: Awesome. Well, it's been great having you on the show, David. Thanks for doing that.

E: This was fun, David.

DC: Yeah, it was definitely a lot of fun for me too.

J: Good job, man. Great.

C: Yeah, you rocked.

S: And thank the rest of you for joining me again this week.

C/E: Thanks, Doc.

J: You got it, man.


S: —and until next week, this is your Skeptics' Guide to the Universe.

S: Skeptics' Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information, visit us at Send your questions to And, if you would like to support the show and all the work that we do, go to and consider becoming a patron and becoming part of the SGU community. Our listeners and supporters are what make SGU possible.

Today I Learned[edit]

  • Fact/Description, possibly with an article reference[10]
  • Fact/Description
  • Fact/Description



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