Sunday, March 26, 2017

When "Normal" isn't Normal

It's not just in the isolated life of a cultist where a false sense of normal can be dangerous.

Let's take a look at an incident from the history of medicine. From the Resurrectionists of the 18th century (aka, body snatchers) and the innovative William Burke, to the ongoing illicit cadaver trade of today, the corpses of the poor have been the mainstay used in autopsies for medical training.

(William Burk was a Resurrectionist whose chosen work entailed digging up graves and exhuming corpses to be sold for study, but he tired of that backbreaking work. He and his accomplice, William Hare, found an easier method. They would ply their victims with whisky, suffocate them in their sleep at Hare's lodging house, then deliver the bodies, some still warm, to a generous doctor.)

Nearly exclusive use of poor people's cadavers for medical studies can be problematic. The poor suffer from malnutrition and chronic stress, and these stresses have an effect on the body, namely atrophy (shrinkage) of some organs and hypertrophy (enlargement) of others. Of particular importance to this story is the fact that the thymus can shrink to one-fourth its normal size due to stress. Assuming that these stress-ravaged bodies represented what was normal was a very bad idea.

In the early 1900's, doctors were searching for the cause of SIDS (Sudden Infant Death Syndrome), which generally occurred in middle and upper-class families. Why had these healthy babies died in the night? To find out, doctors autopsied babies who had died of SIDS. Lo and behold, they found that these babies had abnormally large thymus glands. Had they found the cause of SIDS? Had the enlarged thymus compressed the trachea in the night, suffocating the babies while they slept?

Preventative measures were needed to thwart this supposed killer disease of enlarged thymuses. In the 1920's a method was found to shrink the dangerously large gland - radiation. Babies were treated with radiation which did indeed shrink their thymuses, with the unintended consequence of irradiating the thyroid gland next door, causing thyroid cancer resulting in over 10,000 deaths.

Help finally came from the bodies of babies who died in car crashes. A doctor autopsying those poor little victims in the 1930's discovered that they also had "enlarged" thymuses. Was the disease more widespread than they realized? Or were doctors seeing the picture backwards? Were the so-called "enlarged" thymus glands actually normal size, and the smaller ones abnormal?

Yes, that was the case. Sadly, much damage had already been done.

What can we take away from this? Perhaps it is that we should be very careful in deciding what "normal" is, because once we do, the confirmation bias keeps those fires stoked, and disconfirming evidence rolls off like water off a duck's back. None of us are immune to developing a false sense of "normal."

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