Mary Roach On Our Remarkable, Replaceable Bodies

This message comes from Sony Pictures Classics. How do three friends who dream big stay old friends?

Merrily we roll along from Stephen Sondheim and Maria Friedman, starring Jonathan Groff, Daniel Radcliffe, and Lindsay Mendez. Only in theaters starting December 5th.

This is fresh air. I'm Terry Gross.
Here's the kind of questions my guest Mary Roach explores in her new book. What makes a pig a better organ donor than a goat?

Could a heart survive indefinitely outside a body? How do you remove a deceased tissue donor's bones in a way the family will be comfortable with?

Her book titled Replaceable You is about the latest breakthroughs in replacing body parts from skin to hearts and prosthetic limbs.

With advancements in regenerative medicine, stem cells, and genetic editing, dysfunctioning parts of our bodies are replaceable in ways that were previously impossible.

Mary Roach also writes about attempts to replace body parts centuries ago, including false teeth in the George Washington era and nose replacements in the 1500s.

Roach is known for her books about what makes the human body so remarkable, even the parts or functions we may find embarrassing or disgusting.

She's also known for making her books funny and entertaining.

Mary Roach, welcome back to Fresh Air. So what led you to want to write about replacing body parts?

Well, for one thing, I'm 66 and things are starting to go, so it's kind of ever-present in my head.

Also,

with one exception, my books have always been about the human body in some way, shape, or form. And so this was kind of a logical place to go at my age.

But really,

one of the things that triggered it was a conversation with a reader who had contacted me with a book idea that didn't quite fit my interests.

She wanted me to write about professional football referees.

But it turned out in the course of emailing with her, she's an amputee, specifically an elective amputee.

She's somebody who she'd had spina bifida, her foot was twisted, she couldn't walk well, she could walk but not well, she couldn't hike easily, and she would see people with a prosthetic lower limb walking, hiking, running.

And she thought, well, I want that, but it was very difficult to find a surgeon to remove her foot because it was, quote-unquote, healthy. And she would say, yeah, but I can't walk on it.

And I thought that was interesting, the reluctance of the surgeons to remove a foot because it is

an act with some finality to remove a foot. Trevor Burrus, Jr.: Well, let's stick with that for a while.
You write about how amputations aren't what they used to be.

It's not like the guillotine amputation room. You take like a knife or some kind of blade and like saw off the bones.

I guess decapitate is the wrong word, but I'll use it anyways, decapitate the limb.

So, what's different now? How is it done?

Well, before there was anesthesia, time

was the critical element. In other words, get it off quickly.
Don't be like slowly sawing.

So, now it's an operation that, you know, because the person is out, it can be done carefully. And there are measures taken to try to preclude phantom limb pain.

You can take nerves, the major nerves, and kind of wrap them around muscles so that they have something to do, basically.

So they're not, in the words of one surgeon, a downed power line sparking in the roadway. Trevor Burrus: So let me stop you.
Is that why phantom limb pain is caused?

Because you have nerves that aren't attached to anything so that they're firing, so to speak. They're firing off without any reason to?

And just for people who don't know what phantom limb pain is, once a limb has been amputated, your brain can still send you signals that that limb is causing you pain.

Right, that's right. Yeah.
The thinking is that that helps preclude phantom limb pain. It's just one strategy that's taken.

You can also give someone drugs in the lead up to the amputation to prevent pain, and that's thought to help as well. So there are measures one can take to kind of ward off that scenario.

And, you know,

in the the past or the deep past, what was done was like

cauterizing the wound after the amputation so that you wouldn't bleed out. How is it done now?

Well,

you're still cauterizing

the veins. You're still doing that.

You have to stop the bleeding.

And then you're creating sort of a

you know, you're folding the skin over and creating kind of a padding, a cushioning. And because if somebody's going going to be using a prosthesis,

you want to

have something there between the bone and the socket of the prosthetic.

So how's your friend doing? Does she have phantom limb pain? Does she like her prosthetic leg? Actually, she had her other leg amputated too, so it's prosthetic legs now.

Yeah,

she's doing well.

She was not troubled by phantom limb pain. Her surgeon did take those precautions, and she's doing well.
I mean, it's been tough

having the two

legs amputated now. So

she's getting there in terms of being able to walk on them.

So as a culture, one of the things we're starting to adjust to is the increasingly common use of animal parts to replace human parts.

And I think one of the most common uses is the use of a pig's heart valve to replace a human's heart valve. Why pigs?

Well, you can, to a certain extent, blame Hormel, the pork company. What happened in the 40s, 50s, 60s?

There was a project that was a collaboration between the Mayo Clinic, the Mayo Foundation, which was the research arm of the Mayo Clinic, and the Hormel Institute, which was the research arm of pork.

And

the goal here was to create a smaller pig, a pig that would be a good match in terms of not just the size of human organs, but the function.

So all these studies were done looking at do pigs get coronary artery disease? And it turns out they do. In fact, the pig was described in one of their papers as a caricature of an obese human.

In other words, gets heart disease, has heart issues, doesn't get enough exercise. Aaron Powell, why are those good things? Why does that make it more compatible with a human?

Aaron Powell, well, if you're going to study, if you're going to use the pig as your model, as your stand-in for a human, then you want to be sure that these organs do, that they behave similarly, that they're the similar size.

So this research, once it got rolling and there were dozens and dozens of papers, three volumes of papers looking at kidney function, liver function.

There was one on orthodonture where they had put braces onto pigs. So it was all toward the goal of creating an analog, a stand-in for a human being for trying out surgical techniques or

not so much pharmaceuticals, but techniques and

replacements. So the pig, it became the go-to creature.
I mean, there may be other animals. I mean, who knows? A goat might have been equally useful, but nobody started using goats.

Aaron Powell, one of the big obstacles in transplanting organs, whether it's a human organ for a human being or an animal organ, is that the body rejects this foreign tissue, and the immune system thinks that this foreign tissue is like an invader that needs to be attacked.

So the immune system starts attacking the organ that's saving your life.

So how do they get around that with pig transplants?

Yeah, with an organ that's coming from another species, the reaction is quite severe. It's called a hyper-acute

rejection, where within minutes the body starts to attack, the organ starts to turn black.

You don't want to put a pig organ into somebody without it having been genetically edited. So, one of the things that's edited is something called the alpha-gal protein.

And this is a surface surface protein that the body,

if you can knock that out, you're basically just making the pig organ seem a little less pig-like and a little more human-like.

So now you're dealing with a level of rejection that you would get with a human transplanting. In other words, taking some other human's organ and transplanting it.

So the person is still on an immunosuppressive regimen, taking drugs to suppress the immune system, but

on about the same level as they would with a human organ.

If you keep kosher, like a lot of Jewish people do, you're not supposed to eat any like pig parts,

no pork, no ham. Is a pig transplant considered kosher?

I asked this.

I asked the surgeon who was involved in the first pig transplant, I said, who's Muslim?

And he said, yeah, there are a lot of folks both in the Jewish religion and the Muslim religion who really wish we'd chosen a different species, because I had been asking him, why pigs?

And he said, I get that question all the time. The thing is, he said, we're not eating them.
We are saving lives. So it's okay to get a pig.
organ

if you're keeping kosher. And this was something that were interviews with various religious thought leaders, and there was consensus that it is indeed indeed okay to have a pig organ implanted.

Just don't eat it.

So, you write that the next step in terms of pig transplants is to try to grow human organs in pigs.

I find that very hard to comprehend, so can you explain what the premise is? So do I. Okay.

This is way off in the future, but people are starting to look at it. The term is chimerism.

In other words, a chimera being, you know, part part two different creatures in one. So this would be,

you would take a pig

blastocyst, say, just a tiny cluster of cells, and you would edit it such that it's not going to produce, say, a kidney. And then you're introducing

pluripotent human cells that could grow into a kidney so that this pig would literally be growing a human kidney kidney within its body.

And that kidney could then go to a person as a human kidney would. And the pig, since it's always had that kidney, that human kidney, wouldn't reject it.
So that's what we're talking about.

It's obviously a long way off.

There have been very, very primitive, like sort of

bits of a kidney that have been grown in an animal model, but this is not something coming along anytime soon. But really kind of interesting because

if you go fast forward, I don't know, 100 years, the thinking would be that you could sort of have your own personal pig with a set of organs, kind of like having a car in the backyard for spare parts.

You would have this pig with your organs ready to go when you need them. Obviously, science fiction, way, way out there, but people are working on chimerism.

That's

really amazing.

It is, yeah.

And one of the, I mean, I remember reading an ethics paper on the ethics of this, and they were saying, well, you know, some of the cells sometimes end up in other parts of the animal's body rather than just the kidneys, say?

So if they land in the brain such that the brain starts to develop more like a human brain and the pig now starts to have human kind of awareness and intelligence, now do you need to treat the pig more like a human with different, is there a moral obligation?

I was like, whoo.

That's a lot to wrap your head around.

So you mentioned pluripotent cells, and those are basically stem cells that can change into cells for any part of the body.

And you say that pluripotent cells are the holy grail of regenerative medicine. And regenerative medicine is when you can take cells from a body and regenerate them for whatever use that you need.

Can you tell us more about how pluripotent cells are being used now? Like what the promise is?

Sure.

What's exciting about this is that

you can take an easily accessed cell,

say blood cells from someone,

and you can regress them to the state of pluripotency, which is where cells started out.

Your cells start out just as this pluripotent entity that

becomes eventually part of a kidney or part of a heart or skin.

So if you can get a-

Yeah, yeah, yeah, embryo, fetus, yes. When you're, let's say,

a few cells old,

these are pluripotent cells. And because they have this ability to become whatever, if you can get somebody's adult cells back to that stage, and then you can instruct them with enzymes, proteins,

however that's done, and it's always a highly proprietary thing, you can instruct them to become something else, say a neuron that produces dopamine.

Now

you could have a personalized cure for Parkinson's if you could get that to work. And that's one of the things being worked on.
So in other words, you take some

easily accessed cell like blood cell, regress it to pluripotency, instruct it to become this kind of neuron that produces dopamine, which Parkinson's patients need.

That's pretty exciting. Aaron Powell,

you're basically reverse engineering cells so that they become the kinds of cells that they were in the embryonic stage.

Yeah, you're regressing them. to pluripotency, to the, yes, the stage where they are just basically potential.
And they haven't yet become what they're going to become.

So if you can step in and instruct them the way the body would, then you have this amazing tool. The other thing that's kind of exciting is that if, because right now those would,

it's a bespoke process. You would take the patient's cells and do all this, and it's time-consuming and expensive.
But if you could take,

if you could create what's called a stealth pluripotent stem cell that could evade the immune system, now you can just have off-the-shelf pluripotent cells that you could then give to a patient.

So you're skipping the step of regressing the patient's own cells.

One of the things related to what we're talking about, at least I think it's related, is attempts to regenerate hair or hair cells, hair follicles,

so that you could basically

take hair from one part of your body and have it grow in another part of your body. Now, I know there's already like hair transplants, but this goes beyond that, right?

Right. So this would actually not be moving it from one part of the body to the other.
That's a transplant. This would be

actually

trying to

create

follicles from stem cells, from the two types of basic building blocks.

So, again, it's like you would take someone's blood cells and regress them to pluripotency and then instruct them to become the two types of cells that create follicles.

So, it's an example of what we were talking about earlier.

So, you're not taking cells from the back of the head, say, and moving them as with a hair transplant.

You tried it yourself. Well, you had the scientists scientists try your hair and see if they could

reproduce? I don't know what words to use. So you tell us what they did.

What were you doing, Mary?

Well, okay, so

the company that was involved in the stem cell derived follicle project needed some follicles for study. They needed to understand

what is going on in every stage of development of hair follicles. They need to basically,

because they're reverse engineering this thing. So

they worked with a hair transplant surgeon nearby,

Dr. Shafu, and they had,

when someone was coming in to get a hair transplant, they would say, hey, would you donate some for science? And when I was there interviewing Dr.

Shafu for another chapter, the hair transplant chapter, I volunteered to donate some hair follicles. And while this was going on, I asked

if they wouldn't mind taking some hairs from my head and transplanting them to my leg.

And the reason I wanted this done, I wanted to have a living example of what's called donor dominance.

And in hair transplants, this is why hair transplants work, because the hair at the sides and the back of the head are not sensitive to testosterone like the hair on the top of the head.

So you can take follicles from the back and sides, put them up at the front at the top where the person is losing their hair, and they will now stay there and they will behave like they did on the back or the side of the head.

They'll retain that golden characteristic of not falling out.

So what that means, you could take, and this has been done, chest hair, armpit hair, pubic hair, put it on the head, and it would retain the characteristics.

It would be short, kind of wiry, and quote-unquote difficult to style. That's from a research paper.

But then you could, and if you took a hair, as I did, from the back of the head and put it on the leg, it will now grow to be, you know, six, seven, eight inches long.

And I thought that sounded like a really cool thing to have going on when I'm on book tour. I could pull up my pant leg and I could go look at this long, this luxuriant hair growing on my leg.

This is donor dominance in action. And I was very excited about that.

And they were, bless their hearts, willing to do this. Sadly, it didn't take.

I don't have this hair to show you. Dr.
Shafu was like, it's not going to work. The leg doesn't get enough blood supply compared to the head.
It may not work.

So he was kind of pessimistic, but I had high hopes. That would have been very strange.

I'm sure it would have done very well on social media, photos of that.

Well, we need to take another break, so let me reintroduce you. If you're just joining us, my guest is Mary Roach.
Her new book is called Replaceable You. We'll be right back.

I'm Terry Gross, and this is Fresh Air. This message comes from Schwab.
At Schwab, how you invest is your choice, not theirs.

That's why, when it comes to managing your wealth, Schwab gives you more choices. You can invest and trade on your own.

Plus, get advice and more comprehensive wealth solutions to help meet your unique needs. With award-winning service, low costs, and transparent advice, you can manage your wealth your way at Schwab.

Visit schwab.com to learn more. This message comes from LinkedIn.
Running a business means you wear a lot of hats.

Luckily, when it's time to put on your hiring hat, you can count on LinkedIn to make it easy. Post a job for free or pay to promote it and get three times more qualified candidates.

86% of small businesses find their next great hire in 24 hours. Also, easily share your job with your network.
Plus, manage everything all in one place. Post, match, hire, done.

Post your free job at linkedin.com slash npr. Terms and conditions apply.
This message comes from the International Rescue Committee.

Co-founded with help from Albert Einstein, the IRC has been providing humanitarian aid for more than 90 years.

The IRC helps refugees whose lives are disrupted by conflict and disaster, supporting recovery efforts and responding within 72 hours of crisis. Donate today by visiting rescue.org slash rebuild.

This message is sponsored by DSW, the birthplace of the humble brag. Full of all kinds of shoes that get you at prices that get your budget.

And when there are never-ending options for every style, mood, occasion, and budget, there is unlimited freedom to play. And that's something to brag about.

So go ahead, stock up on fresh sneakers from your favorite brands, or try those boots you always secretly knew you could pull off. Find the shoes that get you at prices that get your budget.

DSW, let them surprise you.

Hi, this is Molly C. V.
Nesberg, digital producer at Fresh Air. And this is Terry Gross, host of the show.
One of the things I do is write the weekly newsletter. And I'm a newsletter fan.

I read it every Saturday after breakfast. The newsletter includes all the week shows, staff recommendations, and Molly picks timely highlights from the archive.
It's a fun read.

It's also the only place where we tell you what's coming up next week, an exclusive. So subscribe at whyy.org/slash freshair and look for an email from Molly every Saturday morning.

So one of the things that you witnessed was, I think it was a hip replacement, right?

And one of the things that really surprised you during that was the anesthesia part.

So at first you thought, well, the anesthesiologist is just sitting here looking at all of the numbers on the printout screen. But then you realized how important the anesthesiologist was.

So describe what the anesthesiologist's job was

before the surgery.

Sure. In the course of my career, I think I've been in operating rooms four, five, six times, and I've always come in after the patient has been completely sedated.

The anesthesiologist almost to me seemed like the security guard kind of sitting there, sometimes scrolling through the phone. And I thought, I guess it's kind of a snoozer of a job.
I don't know.

But I met an anesthesiologist who sort of set me straight on

what has to happen for a person to to become intubated and anesthetized with general anesthesia. And just the intubation element is really tricky.

I went to a seminar he was teaching where the fellows,

they were research fellows, had to become proficient at intubation and they were using a a mannequin, like a head that has little lungs that kind of look like whoopee cushions attached.

And he said, you can try it. And

it's incredibly difficult because there's a lot of stuff going on inside the neck. There's the vocal cords, there's the epiglottis, there's tubes that are branching off.

You know, you're eating and you're breathing starting out with the same tube, then it's going to, you know,

it's like a railroad switching yard in there. Plus, you're doing it with a time constraint.
You have a couple of minutes.

You got like four minutes before the patient would start to have brain damage because with general anesthesia, the patient is typically paralyzed. So, that includes the diaphragm and the rib muscles.

So,

this patient's life is in your hands, and you better get that tube in there. And I was trying, at first, I didn't get the tube, I couldn't get it in, and then I put it too far.

So, I was inflating only one lung and not the other. And if you started it way up higher, you'd be inflating the stomach, and the stomach could burst.

It's like it's really tricky and scary. Trevor Burrus, Jr.: I didn't know when you're under general anesthesia that you actually need to be put on a ventilator for the duration of the surgery.

Is that always true? Or is it just for replacements? Well, I mean, for major surgery, general anesthesia is used, but you can be put out.

Like, for example, for a colonoscopy, you just have, you know, propofol. It's just you're not completely...
There's different levels of sedation. I mean, for a hip replacement,

like the anesthesiologist was saying, you know, we could just do an epidural and the person could be awake, but there's a lot of hammering and sawing, and no one wants to hear that.

It's also about controlling things.

General anesthesia, the patient is completely controlled by the machines in the operating room. And you don't want somebody to wake up in the middle and start thrashing around.

I've never seen, I want to move on to 3D printers.

I have never seen a 3D printer, and I've never seen the results of one, but there are experiments going on now using 3D printers for at least a phase of organ transplant.

Would you explain how 3D printers are being experimented with now?

Sure. I spent a day at the Feinberg Lab at Carnegie Mellon in Pittsburgh, and what people were working on there was

trying to print muscle in a way that the alignment of the cells would create muscle that had the specific function that muscle needed. In other words,

a heart, the heart needs to move in a kind of a twisting motion. It twists as it pumps, so you've got to print the cells.

They have to be in a helix shape, which is different from, say, the hamstring, where it'd be kind of parallel, or the shoulder muscle, they're in a kind of a fan-like shape, which gives you a lot of the versatility of the movement of the shoulder.

So you're not just printing generic muscle, you have to print it in a very specific way to achieve the function that you want it to be doing, which I found kind of amazing.

And no one is printing whole organs, that's way off in the future.

But one of the people there had managed to print a single ventricle that was pumping in a mouse, which was, I mean, it doesn't sound like much.

It's amazing.

It is pretty amazing.

She said, though, because I said, oh my god, you've got a ventricle pumping keeping a mouse alive. She goes, whoa, whoa, whoa.
The mouse still has his heart,

but the blood is going through, and soon they're going to install. They had printed tri-leaflet valves that worked properly, which is amazing.
You know, it's so hard to do.

You also have to think about, you know, if you're going to print something, tissue, it has to be fed. So how are you going to do that? Are you going to print the individual capillaries?

No, you're going to hopefully

let the body grow its own capillaries. Like the science is at kind of at the point of trying to figure out how much do we have to print and how much can we let the body do.

So if you can let the body do it, that's great. You know, when we get fatter, we grow capillaries to serve the fat.

So the body will do a bit of it, but it's not going to instantly create an aorta or something.

Well, one of the researchers said to you, muscle needs nerves also, because without nerves, basically it's meat.

Right, right. And no one is printing nerves yet.
So that's another piece of the puzzle. Still, it's just amazing the things that are in the works now.

I'm wondering if a lot of the research facilities doing research in like regenerating cells and and pluripotent cells and

trying to figure out better,

more effective ways of replacing organs. I wonder if they're losing their funding as a result of all of the funding that was cut during the Trump administration.

Yeah,

this book started to go into production right around the time that Doge got busy. And one of the things I wanted to do for the epilogue of the book is to get back in touch with people and say,

what is going on? Are your projects being cut? Is your funding getting cut? And they were at the phase where they were like, we are all terrified. We don't yet know what's coming.
We don't even know.

There are some projects, you know, 10-year contracts for grants that even though it's a signed contract, they were like, this could be terminated, which is unthinkable.

I mean, all of the work that's gone into that and the patients that will benefit, it's potentially devastating. And I don't know exactly who's had what cut, but I know that

some of the folks who were graduate students and they were about to head out on their careers and they're looking at options in other countries.

So the whole pipeline of innovation and discovery is kind of getting interrupted, and that's going to have terrible effects farther down the line.

I mean, not setting aside the projects that are underway and the patients that will benefit, just looking forward to the future of innovation and medical care, it's very depressing.

We need to take another break here, so I'm going to reintroduce you. My guest is Mary Roach, and her new book is called Replaceable You.
We'll be right back. This is Fresh Air.

This message comes from LinkedIn, delivering candidates who rise above the rest.

With an up-to-date view into shared connections, skills, and interests you won't find anywhere else, Your next great hire is here.

See why 86% of small businesses who post a job on LinkedIn get a qualified candidate within a day. Post a job for free at linkedin.com slash npr LinkedIn.
Your next great hire is here.

This message comes from Capital One. Capital One offers checking accounts with no fees or minimums.
What's in your wallet? Terms apply. See capital1.com slash bank for details.

Capital One NA, member FDIC. This message comes from LinkedIn, who knows how even one hiring nightmare can ruin your small business dreams.

That's why LinkedIn Jobs, new AI assistant, uses insights from over 1 billion professionals to create a personalized shortlist of the best applicants and even finds candidates you would have otherwise missed so you can hire right the first time.

Start hiring with LinkedIn and post your job for free today at linkedin.com slash npr.

I want to talk with you about organ donation.

I know in Pennsylvania, and I'm not sure if this is true of every state, when you renew your driver's license or registration, I forget which, you have to check if you want to be an organ donor.

And you did some research on organ donation.

What did you learn about donating organs, including skin, after you're declared legally dead?

Well, I looked into mostly tissue donation.

Why Why did you focus on that?

Because in another one of my books I had covered organ

transplantation and I felt like I was repeating myself and I had always been interested in the tissue donation element of it because when I wrote STIFF

I could never get access to a tissue recovery

stiff was about cadavers.

Yeah, about kind of post-mortem careers, cadaver research. So I had been to an organ recovery for that that book, so I wanted to focus on something different, tissue recovery.

In other words, bones, ligaments, skin, corneas, all of the other material in a body which can be used and be helpful for patients. And I was curious about

that process. How do you remove these things and then, you know, have a a body that can still have an open casket funeral.

So I want to paraphrase something you say in the book.

And talking about tissue recovery in cadaver labs, you say you were expecting something resembling the Jeffrey Dahmer story, but instead it was closer to UPS. What made you say that?

I said that because

when I arrived in the room where they were doing the tissue recovery, where they would be extracting the bone and the tendon and the skin, et cetera,

one of the people doing it said to me, this is the worst part of the job.

And I had preconceived notions of what the worst part of that job might be, but she was talking about handwriting on labels the same ID number over and over, double-checking, cross-checking the amount of paperwork and labeling, and then at the end, packing and shipping

was the tedious and unpleasant part of her job, not the opening up of a leg and the extracting of bone or ligament. I guess I just wasn't expecting that.
Aaron Powell,

you mentioned at the beginning of the interview that you're getting older and you feel like parts of your body are wearing out.

And I'm wondering how the kind of books that you write that are so explicit about body functions and about research into how the body works and this new book about new ways of replacing organs.

Does that change your relationship to your own body? Does it make you more self-conscious about being in a body? Or has it made you more comfortable with your body?

I

like knowing more about what's going on in my body. And for the most part, it makes me appreciative, I guess.

Like I remember learning about stretch receptors and how you have these, you know, in the intestinal tract, in the rectum, particularly that got these receptors that know when this organ is stretching and filling and let your brain know.

And I was like, that's how it works. So cool.
So I am constantly marveling at all of this stuff going on in the background of myself.

I think that

I'm unpleasant to be around if you're at all squeamish. Why?

Squeamish?

Well, okay, my husband is a very squeamish man,

particularly as regards the eye. And

I was reading this old booklet about the operation of couching where they press the lens down into the lower part of the eye, and he's like,

ix nay on the ouching K. No, like

not, people aren't like me always.

So sometimes I can't sort of share my appreciation for all these gooey bits and pieces of us that are performing miracles on a daily basis. Aaron Powell,

there are some things that the body does, as you put it in the background. And it's probably a good idea not to be too conscious of it.

And I'm thinking of like digestion, what the large intestine is doing, what's passing through it.

Breathing, like unless you're like meditating or something or you have like breathing problems, if you're too conscious about your breathing without that consciousness having like some kind of function, it can be very distracting.

It's best probably if you just do it.

And there's all kinds of things. If you focus on it too much, it's easy to start worrying about it.

Aaron Ross Powell, yes, there's something called heart awareness where you become too aware of your heartbeat and what it's doing.

And I think that creates anxiety and then your heart does start doing weird. I think, yes, it's not necessarily helpful to be tuned into all this.
And I don't think that I am.

I'm trying to think of an instance where I feel like I know too much.

I know when I worked on gulp. About the digestive system.

About everything between the nose and the butt, the weird tube with all the bacteria and everything.

I became really aware of what's going on in your mouth when you chew, the process of bolus formation, where you're taking a piece of meat, say, and you're breaking it down, and then you're putting it back together in a bolus that's a shape that can slide down the throat.

And I visited somebody who studies chewing and this process and what the jaws do. And I remember for a while after that, going to restaurants and thinking, looking around

at people chewing and swallowing, and thinking, this is disgusting. Like,

people should have sex in public and eat in private.

It's absolutely disgusting.

One more question.

There's a French expression, belle lad, and I'm not sure exactly how to pronounce it. But it basically means beautiful, ugly, which is, I think, a good way of describing a lot of parts of the body.

There's something really like ugly and weird looking about some of the parts, the internal parts that we don't see. But there's something really magnificent and beautiful about it, too.

Do you feel that way about parts of the insides that we don't get to see?

Very much so. I mean, if you ever see a liver, well, you've seen a I mean, no, I haven't seen a liver liver.
I've seen a chicken liver. A beef liver, say.

It's kind of a glistening, streamlined, kind of beautiful object.

It's not creepy, I don't think. And a heart, hearts are surprising.
Like if you see a heart inside somebody's chest beating, and I saw this on an organ recovery, it's surprisingly active.

I mean, you think from your own heartbeat that it's sort of a very gentle kind of motion, but that thing's like squirming around in there in this little space. It's kind of extraordinary.

And it's doing that over and over and over and over for, like, if you're lucky, 80, 90, 100 years, and it keeps on going. And like, what thing that you buy at Best Buy keeps going that long?

It's the kind of thing I try not to think about a lot.

Don't think about it. Just don't, just let it do its thing and don't think about it.
Yeah, yeah, yeah.

Mary Roach, thank you so much for talking with us. It's always a pleasure to have you on the show.

Thank you so much, Terry. Always a joy.

Mary Roach is the author of the new book, Replaceable You. Coming up, an excerpt of an interview with me.
I'll explain after a break. This is fresh air.

Support for this podcast and the following message come from Humana. Your employees are your business's heartbeat.

Humana offers dental, vision, life, and disability coverage with award-winning service and modern benefits. Learn more at humana.com slash employer.
Support for this podcast comes from GMC.

At GMC, ignorance is the furthest thing from bliss. Bliss is research, testing, testing the testing, until it results in not just one truck, but a whole lineup.

the GMC Sierra lineup featuring the Sierra 1500, the Sierra Heavy Duty, and the all-electric Sierra EV. Because true bliss is removing every shadow from every doubt.
GMC, we are professional grade.

Visit GMC.com to learn more. This message comes from Dell.
It's time for Cyber Monday, one of Dell Technology's biggest sales of the year.

Enjoy huge savings on gift-worthy accessories and select PCs like the Dell 16 Plus featuring Intel Core Ultra processors. Shop now at dell.com/slash deals.

This month marks my 50th anniversary hosting the show. Is that long enough to get me in the Guinness Book of Records? We're fact-checking that right now.

When I started hosting in 1975, Fresh Air was a local show, three hours a day, five days a week, heard only by listeners to WHYY in Philadelphia. We didn't become a daily NPR show until 1987.

In recognition of my anniversary, I was invited invited to be a guest on a podcast that I like a lot called Talk Easy, hosted by a terrific interviewer, Sam Fragoso.

In a special collaboration between Fresh Air and Talk Easy, my interview with Sam, or I should say his interview with me, is now available on both podcast feeds.

To give you some sense of what it's like, we're sharing a short excerpt. It comes in a part of the interview about my upbringing in Brooklyn.
One of my answers was kind of embarrassing.

You'll know when you get to it because I I prefaced the answer with, I'm too embarrassed to reveal that. So here it is, a preview of my interview on Talk Easy with Sam Fragoso.

You said once that you were, quote, brought up believing that there's some positive value in thinking negatively.

Oh, yes.

I think it's a very Kinahara Jewish thing.

If you think something is going to turn out badly, then

you won't be disappointed when it turns out badly. Sounds a little bit like a Melbrook's quote.
Hope for the best, expect the worst is a quote.

It's a quote from one of his lyrics, and that's like, when asked for, do you have a motto? That's what I always say. That's your motto.

But also, it was like, if you expect good things to happen, they're not going to.

You know, it went along with my father's

expression: no one ever said life was about pleasure. You know, like weekends, you get some time off where you're allotted a certain amount of pleasure.
But during the week, it's like.

What was your mother's motto? She didn't really have one. Yeah.
Most people don't have mottos. Yeah.

I mean, it wasn't literally his motto, but it's something that I heard and certainly that I probably internalized.

Taking this maybe too literally, but like, what did that inner monologue of thinking negatively sound like for a young Terry Gross?

Frustrating, a little annoying, but I think I internalized it anyway.

What part was frustrating?

Well, you know, you want some time for pleasure. And like when I was a little child, this was more when I was a teenager.
Right.

When I was a teenager, I was still a really good student, doing really well in school, but hanging out,

I wouldn't exactly call myself a theater kid, but we had something called sing in Brooklyn schools where you write a long sketch, take Broadway melodies, and write lyrics to those melodies.

So I was one of the lyricists. For all four four years, you were one of the lyricists, right? For at least three of them.

But anyways, yeah, I want to pleasure in my life. Being a lyricist sounds pleasurable.
Oh, it was. It was great.
I loved it.

When you were writing those songs in high school, it's my understanding that you once overheard basketball players sing your lyrics. Now, you remember what those lyrics are, don't you?

I'm too embarrassed to reveal them. Hold on.
You've said in the past that you won't say them. What if we sang them together? We're not going to do that.

There's no way we're going to do that. You don't even know the lyrics.
Well, if that's why, if you teach me, just give me a line.

Imagine yourself as Stephen Sondheim. Give me one line.

Okay. I may live to regret this.
That was the alternate title of your book, right?

The alternate title of a lot of my life.

Okay.

So the premise, it was kind of like a ripoff of How to Succeed in Business Without Really Trying, where the main character finds like a rule book for success, like a self-help book for success called How to Succeed in Business Without Really Trying.

We kind of used the same premise.

And the premise was that we wanted to be like cool and we didn't know how to be cool. We needed a handbook.
I wish I had that in high school. Or that we were going to create the handbook.

I think we needed the handbook. And so the melody was to Lechaim from Fiddler on the Roof.
And the opening lyric was, the book will be our mentor, our noteworthy source of the rules.

It will teach us explicitly in sheer simplicity, step by step, to be cool. The school will marvel at how cool and groovy we look.

They won't suspect that the gimmick is that we are mimickers of a 16-page book or or something like that. 60-page book.
Excellent. I'm done.
Excellent. I'm totally done.
With the interview?

No, no.

I'm not going to pull a mammoth.

Or a Bill O'Reilly. Or a Bill O'Reilly or several other people like Faye Dunaway.
Or Faye Dunaway. Or Monica Lewinsky.
Or Monica. Or Lou Reed after six minutes in 1996.

Yes. I can keep going of fresh air walk-ups.

It's an illustrious roster, I have to say. There's a really great roster.

That was fantastic. Listen,

if I really live to regret it, you're going to know about it.

I believe it. And as will our listeners.
That was amazing.

I don't hear the compliments. I don't hear like.

I said that was amazing. No, you think it's amazing that I revealed it.
Yeah, you're right. You caught me on that.
I know.

When you were sharing the lyrics, I was like, God, how am I going to remember to sing all these? This is

very long. Was it satisfying to hear your fellow classmates singing your words? Oh, it was great.
I felt so affirmed because I wasn't in with like the basketball crowd,

even though I was what was called a booster, not a cheerleader, but somebody who just kind of screamed loud and got to wear like a special jacket with the team's name on it.

But I didn't really know the guys. And they were like the cool guys in school.
So a couple of those guys singing a lyric that I'd written that was like, whoa.

That was an excerpt of my interview on Talk Easy with Sam Fragoso. You can find this episode in the Fresh Air podcast feed as a special extra episode.

And of course, you can also find it on the Talk Easy podcast and online at talkeasypod.com. A video version of this interview will be on YouTube later this week.

Tomorrow on Fresh Air, we'll talk about how Charlie Kirk became a leader of the conservative youth movement and a close associate of President Trump and Don Jr.

We'll talk with Robert Draper, who wrote a profile of Kirk in the New York Times magazine earlier this year, stayed in touch with him, and continued writing about him.

Draper covers the political dynamics of the right. I hope you'll join us.
To keep up with what's on the show and get highlights of our interviews, follow us on Instagram at NPRFresh Air.

Fresh Air's executive producer is Danny Miller. Our technical director and engineer is Audrey Bentham.
Our managing producer is Sam Brigger.

Our interviews and reviews are produced and edited by Phyllis Myers, Herberta Shorrock, Anne Ree Boldonato, Lauren Krenzel, Teresa Madden, Monique Nazareth, Susan Yucundi, and Anna Bauman.

Our digital media producer is Molly C. V.
Nesper. Our consulting visual producer is Hope Wilson.
Thea Chaloner directed today's show. Our co-host is Tanya Mosley.
I'm Terry Gross.

Hi, it's Terry Gross with a deal to propose, a way to help you and Fresh Air. If you sign up for Fresh Air Plus, you'll get bonus content and daily fresh air episodes without ads.

You'll also be supporting Fresh Air and public media. Learn more and sign up at plus.npr.org.
This message comes from Vital Farms, who works with small American farms to bring you pastor-raised eggs.

Farmer Tanner Pace shares why he chose to collaborate with Vital Farms when he brought pastor-raised hens to his small Missouri farm.

Probably the best thing about being a Vital Farms farmer is working with a group that is not just motivated for one thing.

They're motivated for the well-being of the animals, for the well-being of the earth. They care about it all, you know, and that means a lot to me.

To learn more about how Vital Farms farmers care for their hens, visit vitalfarms.com. Support for NPR and the following message come from HomeServe.
It never happens at a good time.

The pipe bursts at midnight. The heater quits on the coldest night.
Good thing HomeServe's hotline is available 24-7. Call to schedule a repair, and a local pro will be on their way.

Trusted by millions. For plans starting at $4.99 a month, go to homeeserve.com.
Not available everywhere. Most plans range between $4.99 to $11.99 a month your first year.

Terms apply on covered repairs.