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Freakonomics Radio

Bad Medicine, Part 1: The Story of 98.6 (Rebroadcast)

Freakonomics Radio

Freakonomics Radio + Stitcher

Documentary, Society & Culture

4.632K Ratings

🗓️ 17 August 2017

⏱️ 44 minutes

🧾️ Download transcript

Summary

We tend to think of medicine as a science, but for most of human history it has been scientific-ish at best. In the first episode of a three-part series, we look at the grotesque mistakes produced by centuries of trial-and-error, and ask whether the new era of evidence-based medicine is the solution.

Transcript

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0:00.0

Hey there, Freakinomics Radio listeners. We are taking advantage of August to replay you a special

0:05.2

three-part series we did last year called Bad Medicine. Today, part one, the story of 98.6,

0:13.5

and it starts right now. We begin with the story of 98.6. You know the number, right?

0:21.5

It is one of the most famous numbers there is because the body temperature of a healthy human being

0:27.1

is 98.6 degrees Fahrenheit, isn't it? So now I'm going to take your temperature if you don't mind,

0:35.6

just open your mouth and I'll insert the thermometer. Perfect. The story of 98.6 dates back to a

0:46.3

physician by the name of Carl Wunderlich. This was in the mid 1800s. Wunderlich was medical director

0:53.0

of the hospital at Leipzig University. In that capacity, he oversaw the care and the taking of

1:00.7

vital signs on some 25,000 patients. Pretty big data set, yes? 25,000 patients. And what did

1:09.6

Wunderlich determine? He determined that the average temperature of the normal human being

1:17.1

was 98.6 degrees Fahrenheit or 37 degrees centigrade. This is Philip McCovic, a professor of medicine

1:26.8

and a medical historian at the University of Maryland. Well, I am an internist by trade and

1:33.2

an infectious disease specialist by subspecialty. So my bread and butter is fever.

1:39.7

There's one more thing McCovic is. I am by nature skeptic and it occurred to me very early in my

1:49.6

career that this idea that 98.6 was normal and that if you didn't have a temperature of 98.6,

1:58.2

you were somehow abnormal, just didn't sit right. Philip McCovic, I have to understand, cares a lot

2:06.0

about what is called clinical thermometry. And if you care a lot about clinical thermometry,

2:11.4

you care a lot about the thermometer that Carl Wunderlich used to establish 98.6. His thermometer

2:19.6

is an amazing key to this story of 98.6. So you can imagine how excited McCovic was when

2:27.9

on a tour of the weird and wonderful Mooter Museum in Philadelphia, the curator told him

2:33.8

they had one of Wunderlich's original thermometers. I said, good heavens, may I see it? And she said,

2:41.5

sure, would you like to borrow it? And I said, of course. And so I was able to take this thermometer

...

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