Return of Alpha Gal

Hello, it's Lulu, it's summer here in the Northern Hemisphere, which means the ticks, the ticks are out and also the barbecues are out, you know, hot dogs, hamburgers, ticks, and burning meat, which made me think of today's episode, which combines the two into a wildly yuri, scary, but perhaps hopeful, ethically complex tail. It's one of my all-time favorite radio labs, and we're gonna play it for you today. It is 10 years old, but lucky for you, it has a pretty thrilling scientific update at the end. So here we go. Yeah, wait, wait, you're listening to radio lab. Radio from WNYC. Good. Okay. Is your mic on? Yeah, I'm getting, this is making me nervous. Maybe I should get my happy pen. Are you allergic to radio greatness? That I know of, I've been really exposed to it, yeah. Anyway, let's go. Are we rolling? We're good? We're going? We are rolling. Okay. I'm Robert Kroll, which this is Radio Lab, and today we're going to begin with a conversation between Dan Pashman. Okay. Host of a podcast here at WNYC called The Sportful. It's about food and Amy Pearl. Amy? Yes. A digital producer here at the station who likes food. And the conversation they had was about something that happened to Amy, which she never expected, certainly didn't want, and yet it could happen to any of us at any time. So years ago, for any of this happened to you, just tell me what was your relationship with meat? My relationship with meat. Yeah. Well, you know, how when you're little and your mom is like, you can have any special dinner for your birthday, my dinner was meatballs. And she was like, except meatballs are so hard to make, so it was pot roast. And then Peter Luke, you know, Peter Luger. Same as steakhouse in Brooklyn. Yeah. I used to go there quite often, and I live there, and I have a Peter Luger credit card. Are those hard to get? You know, I don't, I don't know how they give them out, but nobody seems to have one. I don't think they give them out anymore. But I mean, I was very into Peter Luger. I was living in Williamsburg, and it just, it opened at like one o'clock every day, and you could just walk in at one. They had an amazing bar. There's a no tablecloth on the table. These old German waiters. They bring out your porterhouse for three. They put a little plate upside down and then put the big platter on top of it, so it's tilted and all the juice runs to the end. And then they like have the special double spoon thing that they somehow like scoop juice onto your steak, and oh, so good. And also like the smell of burning fat from a hamburger. I mean, I love hot dogs so much when you bite into them, and they're like, and have like a snap and like having a weeny roast out in the open air. It's just it's like the, oh God, it's so good. Anyway, I, I was always very into meat. What changed? Oh my God. It was terrible. It was what happened was I was having this beautiful. It was springtime. I was having a beautiful leg of lamb with some neighbors, and we like put it on the grill. And it was just a delicious, beautiful dinner, and I had served with it some ramps that I foraged in my mom's yard. By the way, it's just a wild onion. And so, so we had this delicious meal, and then you know, I went home and I was going to sleep at like midnight, like a few hours later, and I just felt weird. I was like, oh God, something's wrong. I feel like really anxious, like something's wrong with me, and I went in the bathroom, and I like look in the mirror, and my face was like, oh, weird looking. I just like, I kept laying down, be like, I'll just sleep it off, whatever it is, but every time I lay down, I feel like I was going to faint, so I was like, prop myself up, and I was like, oh God, I'm having terrible stomach cramps, and just like a weird feeling of impending doom. You know, but just like anybody, I'm just like, just get a good night's sleep. This will pass. I like splashed a little water on my face. I mean, I don't know what made me think this, but I thought like maybe a snail, a tiny snail was on one of the ramps that I ate. And it was like poisoning me somehow. You know, snails, I mean, they probably poisonous. So I called my friends in the morning, I was like, hey, how you guys doing? How was dinner? They were like, oh, so great. I was like, really? So great. Nothing weird. No horrific panic attacks. And they were like, and they were like, oh, so lovely. Thank you so much to do it again. I was like, wow, I really had a rough night. And but I didn't think anything other than I went on with my life, you know, just like whatever. And then about a week or two later, I made some cheeseburgers, and I ate a cheeseburger, and I was watching goodbye, Mr. Chips. Really tear-jerking movie and a good book, too. And about a couple of hours after I ate, I was like, started to feel really weird. Again, I was like feeling like I was like, I had to stand up. I was like, I think I'm gonna faint. I feel really light head. I can't catch my breath. I feel like really woozy. But if any time I lay down, I really felt like I was gonna faint. So I was like trying to stay sitting up right now. I was like, oh my god, this is very summer. I ran into the bathroom, and I was like looking in the mirror and lo and behold, I'd hives all over my stomach, and then they started coming out of my hands. And I was like, oh my god, something's happening. And at one point, I did get up and unlock my door, because I did feel like I'm gonna pass out, call an ambulance, and then they're not gonna be able to get in. So I mean, I was in a little bit afraid of what was happening. And when I woke up in the morning, the first thing I did was Google Sudden Meat Allergy, because I was like, this seems like an allergy. And the only thing that was the same was meat. And I'm going through, and like the second thing that came up was this article that was like Florida Man has Sudden Meat Allergy. I was like, oh my god, I think it's a possible I could have this. And I made a appointment with my doctor. I brought in the article. I'm like, I'm gonna be this person, but I can do it. I had the article in my pocket. What, what, what person? You know, the person that goes to their doctor was something I found on the internet. So I brought the article. It was in my pocket. And like, I got through the whole, like, check up. And I was too chicken. I went when I was paying the receptionist. I pulled it out and gave it to the receptionist. And I was like, could you give this to the doctor? So that was like the best I could do. And then I did call my doctor and had a conversation with him on the phone, asking him if I could get tested. And he was like, no, there's no such thing as a meat allergy blah, blah, blah. So some people think allergies are just like in your head. This is science writer Peter Smith. We got in touch with him after we heard Amy's story because Peter is an investigator of many things, including strange allergies. And people are like mushrooms hurt them or they think Wi-Fi hurts them. Yeah, Wi-Fi hurts them. And I don't know. And when I producer a lot of NASA and I got into the studio and we told them about Amy's story, he said, yeah, all right. I know exactly who you need the doctor. Oh, yeah, hi Thomas Platt's Mills. This is Thomas Platt's Mills. That's right. How are you? I'm very well. Dr. Platt's Mills is down at the University of Virginia in Charlottesville. He's a professor and he works at an allergy clinic. We're constantly sifting through stories, which not only you don't believe, but are actually nonsense. And he told us in the last 10 years or so, he started hearing lots of stories just like Amy. Right. Somebody shows up at the office, convinced that they're allergic, all of a sudden, for no apparent reason, to read meat. The first time I heard it was probably as early as 2004. And every single time he heard the story, he would tell the patient exactly what Amy's doctor told her. Now, no way. No, no, no, it's not possible. Right. So what was wrong with these complaints in an orthodox medical way? Oh, everything. Adults don't become allergic to something they've eaten for 40 years out of the blue and certainly not read me. So you're basically saying to these patients, I think you must be making this up because I can't explain it. Well, I don't, I don't use language like that. I say, I say that there's a, I was, I was trying to do your inner voice. Oh, you don't want to know what doctors are thinking in their inner voices. You know, you often think in the middle of interview, is it possible that he's got, you know, some ghastly disease? That gap. Yeah, you know, the point is that when he'd hear a story like Amy's, he just didn't believe it. But then everything changed. Thanks oddly enough to a cancer drug. This new cancer drug called Sittuximab. In New York today, Martha Stewart was indicted on criminal charges relating to. This is the very drug that got Martha Stewart and all that trouble for insider trading. Do you remember that? I went to jail for six months? Yeah. Anyway, very promising, exciting new drug. But then. Doctors were giving people this injection and it would just like end up on the floor of the doctor's office. In shock? Yeah, there would be an anaphylactic shock. Their hearts would start beating faster, they'd get short of breath, they'd get stomach cramps. Their immune system would just. start to overreact to something new and alien that came in with the drug, basically a classic allergic reaction. So the mystery lands on Thomas Platt's mills' desk. Yes. So we were asked to look at Sir Tux amount to see if they could figure out what was causing the reaction. And he tests two groups of blood, a control sample, and then people that have this allergy. And he quickly zeroed in on a particular molecule, a sugar that was part of the drug. This sugar, galactose alpha-13, galactose, or alpha gal. Alpha gal? Yeah. As in a particularly great lady, better than the beta or gamma gal? It's like alpha male, but alpha female didn't quite have a ring to it. It's like alpha. Anyway, it seemed like alpha gal was the culprit. Yeah. And if you told me four years earlier that there's a whole lot of people out there who are allergic to this sugar, I'd have thought you were smoking, you know, vaping again. Because not only does this sugar alpha gal show up in the cancer drug, and this is where he gets back to Amy, it also shows up in the blood of mammals. All non-primate mammals. So every time you eat lamb or beef goat, camel, even tripe or pig's kidneys, you're also eating alpha gal. So I'm reading this article and it says like, it's this thing called alpha galactase or alpha gal or whatever. So it made no sense that someone like Amy, who'd been eating meat all her life would suddenly somehow be allergic to alpha gal. I just was like, this was so stupid though. So one day. It's getting to be barbecue season. I usually have like a couple of barbecues where I just do a whole pork butt and a brisket and like hang out all day doing it and I was like, very wanted to do that. And I was like, I'm just gonna not eat meat and not even know. So I was like, forget it. My doctor will test me. I'm gonna test myself. So I was like gonna be very careful. I got a thing of Benadryl and I was like, I'm not gonna do it alone. I'll do it with my mom, my poor mom. And so I went up to my mom's and she's like really into food too. So she was like, oh, it's so exciting. I got two porterhouse steaks and salads, do you explain to her what you were testing? Yeah, I did. Cause I had talked a little bit about it with her. So like fire up the grill, do the porterhouse. I even think I like Instagram to does a joke like, ha, ha, ha. This might be the last time you hear from me. But so, you know, we're having a nice summer day just me and my mom having our steak. I only ate like a couple bites cause I was slightly nervous and I was like sitting in the grass with my dog and reading a book and trying to think like, do I feel normal? Which try it, folks, it's hard to figure out when you start asking yourself, do I feel normal? Does this, am I breathing? Oh, it's my stomach hurt, it's something wrong. And I was like, after a while, I was like, oh, I feel pretty good. And the neighbor came over and was like chatting with us and it was in the middle of that conversation where I was like, I kind of feel like I have to go to the bathroom. But maybe I just have to go to the bathroom. So I went to the bathroom and I was sitting there and I was like, oh, God, something feels bad. And then I was like, oh, God, I definitely, this is not right. Something's wrong. And I went in to get the benedrill and I took the benedrill and I went on my bed and I had the guest room at my mom's and I was like sitting on there and I was like, oh, I just feel right. Maybe I just take a deep breath, I'll just stand up. Maybe I just put my hands over my head like this. Oh, that does feel slightly better, I think. And then I was finally like, I think we should go to the hospital. And I went outside and I was like, mom, I think you have to drive me to the hospital. She was like, talking to her neighbor like, what? Oh my God, honey, what? Oh, let me go change my clothes. Like, mom, you know, she's not wearing the hospital level clothes. So I'm like, okay, hurry up, mom, mom, are you ready, mom? And then I was like, while she was changing her clothes, I suddenly was like, oh, my God, got my wallet out of my cell phone and I like threw it toward my mom's bedroom door. And I was like, here's my insurance card, call an ambulance and I just like hit the floor. Eventually, the ambulance arrives and I got stabilized. I was strapped to the thing, I was in the emergency room like they were shooting me full of, I don't know what, epinephrine and adrenaline and the little like 12-year-old emergency room doctor runs in and he was like, I looked it up on the internet, AlphaGal fascinating. What? That's terrible. I've never heard of that. Could it be true? Yes, it's true. Like, they're all having a discussion there. Then when I went back to my doctor after that and I was like, hey, just get out of the emergency room because they tested me for AlphaGal and I'm allergic to meat. So this is an allergy? Yeah. So all of a sudden you're looking at the quote, "crazy" and they're not so quote, "crazy" anymore. Absolutely. We suddenly had a blood test and of course what turned out is all these patients who've been telling us this story were allergic to AlphaGal. But it's still like a mystery. Right. Thomas Platt's mills couldn't figure out why people like Amy, who had lived for 40 years eating porterhouse steaks at Peter Luger's with a credit card, why would she suddenly develop an allergy now? There would gotta be some kind of trigger. Yes. So we were looking for anything that could explain it. It could be a mole, it could be a nematode, a worm, or a fungus. But then he looked again and noticed that all the people who had had bad reactions to the cancer drug. They were in a particular area of the country. Was Virginia, North Carolina, southern Missouri, Arkansas? No cases in Salt Lake City, no cases in Denver, just matterings down the west. So he turned to his technician Jake and he said, "I said you've got to Google every map you can find and say what matches that area?" Creatures or diseases that appear wherever the allergy appears. So Jake starts googling, googling and googling and eventually he comes across a map that matches where the cases are very beautifully. The maximum area for Rocky Mountain spotted fever. So he made this little map and it's like the shaded, dark areas of the country are places with a Rocky Mountain spotted fever and then there's like some stars where this allergy had appeared. And they overlap. Oh, very interesting and then all of a sudden it clicks. Rocky Mountain spotted fever is a tick-borne disease. This is the distribution of the Lone Star tick. And actually just a little before this it turns out an allergist down in Australia, Cheryl Van Nune. First name Cheryl is H-E-R-Y-L, Van Nune and V-A-N, and then N-U-N-N, and I'm from the tick-in-gist allergies research and awareness center in Sydney, Australia. She says she was now being visited by all kinds of people who claimed suddenly to be allergic to me. And whenever I take a history, so for example I'd ask them was there a family history of rhinitis, exmer, asthma, stinging insect allergy and they say they've all been bitten by ticks? When we started asking patients we suddenly heard the stories just out the kazoo. But at this point Dr. Platt's mill is all he has is a map, some stories, and a hunch. Right, so. So what does he do? He decides, well, maybe I'll just do this to myself. He does what? He decides to test it on himself. Oh my god. He sort of like denies that he did it intentionally. I know I had no intention. I mean, I think he also likes to walk and amble and think about things. Right. So he goes for a long walk, along the Blue Ridge Mountains. And I knew I wanted to be off trail because I'm actually rather allergic to humans. So he's walking and walking and walking along the way. He bumps into a whole bunch of ticks. And if you walk into a nest of those things, oh my god, this sounds like a nightmare. Yeah, absolutely. I got 200 seed ticks. And then in November that year I was taken out to dinner and the lamb chops were particularly delicious, and the French wine was delicious. And six hours later I woke up covered in hives. He's got an allergy to red meat, all just because of the tick bite. Tick bite. That's right. Go bite you right back after this. I'm Robert Crowich. This is Radio Lab. Now we go back to Amy just when she's discovered that the allergy to meat that she has developed comes from a tick bite. A tick bite? Hang on a second, because like a few weeks before all this started happening, as I said I was foraging for ramps and my mom's backyard. And I had a tick on my arm. Now it turns out that not only was that tick bite a terrible thing for Amy, it was a kind of double tragedy. Hidden from view amongst the trees, and in the undergrowth. And I think it's only right at this point to back up, and consider the story from a tick's point of view. (dramatic music) - Okay, so I'm Graham Hickling. I'm a wildlife disease ecologist at the University of Tennessee. - So I was wondering if you could help us tell the story of, in this case, the loon start tech that bit Amy. - Oh yeah, sure. So they start off in this little pile of eggs, perhaps a mass of 2,000 eggs. Under the leaves, the proud mom just gave birth. At that point, she's just a kind of a withered husk. - Meaning dead. - But anyway, a few weeks later, those eggs will hatch and this mass of 2,000 baby ticks emerge from under the leaves. - And could I see them with my naked eye? - If you ran into a mass of them all up together, you would feel like you've got a little smudge of dirt and then the dirt starts walking. And so they'll just climb up and they'll, you know, potentially all be on the same leaf or the same twig. - Looking for something to feed on. Now, one teeny little tiny problem for these teeny little tiny ticks is that they dry out. So when they come up from under the leaves, they come up briefly and then they go back down. Get a little water, come back up, get thirsty, go back down and rehydrate. - So they like commute. - Exactly. And we refer to the behavior as questing. - Oh, questing. - So if you were one of these little baby ticks up questing for food while you're up there, you are essentially velcro. Because on each one of your little eggs, you have little kind of hot-like structures. And so you're flat against the leaf. - Sort of sniffing in the air with your two little front legs. - I can detect CO2 heat movement. - So let's say one day you're sitting there on your leaf and you pick up the scent of a nearby mouse. - My, so the potato chips of the ecosystem, everything eats them. - You might be about to have your very first meal. - So you basically stand up, stretch out all your little eggs and do a tick dance. And so it's kind of interpretive dance, like movements. - While you're waiting for that mouse to come just close enough that you can grab onto it. So you're dancing and you're waiting. And you're dancing and you're waiting. - To be honest, you are probably going to wait your entire life and die unfulfilled. It's because there are 2,000 of you starting off and a stable tick population. There's only going to be two of you that survive. - Oh my gosh. So 1,998 little baby ticks are born and then that's it for them. But let's say that you're one of the lucky ones. And one sunny day there you are hanging out on your little leaf when you detect two incoming mammals. One is a 40-year-old hominid, the other is her dog. So you perk up, you thrust your legs out, wave to the tick dots, and say that you're waving and you're dancing and you're hoping and slowly, the dog's getting closer and closer and closer and you reach out with one of your tiny little limbs so you can grab on and eat and survive. - But the reason that tick ended up on me was I slept in bed with my dog naked. I mean, she's always naked but I was also naked. I mean, that's not gross. I don't, I mean, that's so weird. - No, but how do you know that's when it happened? - Because I know that like I did a good tick check on myself and I took a shower and everything and then in the middle of the night I woke up with an itching sensation and I went to the bathroom and I couldn't really see what was on like something was on the back of my arm and it was a tick. - So as the tick is biting into Amy, what is it giving Amy that's gonna make her allergic to me? - Well, I need to stop you there, Robert. - Difficult one, Robert. - I don't know the answer to that. - That's Peter Smith and we're joining us as Sheryl Vanden and the scientist. - It's all up for speculation. - We don't really know, but here's the theory. - So normally when you eat a piece of meat you put alpha gal in your stomach and your stomach digest it and it's in your body and there's no big deal. - But the tick canningly will drill into you, poke into you and injects. - It's saliva. - We'll call that ticspet. - Ticspet into its victims. - Straight into its victims largest organ for skin. - And ticspet has an anti-clotting factor, nanosthetic, anti-inflammatory compounds. - And we think the alpha gal. - Now Peter says the thing about the skin is the skin is like this enormous like surveillance system. - It's always on the lookout for invaders. So when the alpha gal comes through your skin covered by all that bad, bad ticspits stuff. - That's gonna really like set off your immune system. - The immune system freaks out like, oh, uh-uh. - And the alpha gal covered now in bad spit. Almost sort of by mistake gets labeled bad and now it's on the bad guy watch list. So. - Therefore the next time you eat meat the mate comes in. - And then the body unleashes wave upon wave of chemical attacks to do battle against this alpha gal. - And this reaction gets way out of hand. You got so many antibodies, multiply, multiply, multiply, multiply, multiply, making you, rather than this case, Amy, feel just horrible. - Right. - I mean, it's very weird. It sounds like a science fiction movie. It sounds like the beginning of a science fiction, at least kids book, let's not go to movie. But like, it's, it's just strange. - Which all goes to say that this really is a kind of double tragedy for Amy and her tech. - Yeah. - 'Cause text didn't evolve to, like, humans. - Right. - We're a mistake. - Like, we have opposable thumbs. - We're either gonna pull them off. - I actually woke my mom up and she helped get it off. - Or if they drop off, they're gonna drop off in an airport terminal or a Walmart coper or somewhere like that. - Or a shared carpet or a shared carpet indoors. - And, and they doomed. - And for us, well, we lose something that historically anyway is a big part of who we are. - Yeah. - Because we have, we, we adapted in the grand evolutionary scheme of things to like eat flesh, to eat meat. - Yeah. - Yeah. - I mean, I'm actually sitting here picturing a steak, but actually the thing, I mean hot dogs, like, wrap ramps around a weenie and roast. Yum, that sounds so good, my mouth's watering. (laughing) Weenies and ramps. - Yeah. - But, I am going to my allergist tomorrow 'cause I did, you know, I was reading about this allergy a lot when I first got it and I read that for some people, the allergy can fade away. So, I'm gonna get a blood test to see what my blood level of alpha gal is. So, I'm a little-- - So, what are you hoping for tomorrow? - I want to be normal. - Again. - That was the end of the Dan and Amy conversation. She was gonna go to the doctor, get herself tested, find out whatever. So, we asked her back in. - Okay. - To find out what happened. - So, I actually did get an appointment with my allergist, Dr. Corn. (laughing) It was Dr. Corn. She's really nice. So, I got the appointment, I got the blood draw, whatever. And a few days later, my doctor called me and she said that my numbers were still really high. And I was like, well, how high are they? And she was like three. And I was like three. That's not high. And she was like, they're supposed to be like one or something. So, they had gone down, but they were still, you know, many times more than they should be. - But when you left and were waiting for the call, were you waiting with the hope that you would soon be eating a bit of hot dog? - I mean, honestly, I was hoping no. - No? - No. - I don't know. - Wait, you are, you are the great, you, you, you. - No, but I was afraid that she would be like, oh my god, your numbers are so low. I think you could probably eat meat. Let's do a food challenge. I would be like, ah, 'cause like, that's such a scary memory. Yeah, I don't, you know, actually just the other night, I was eating at an Indian place and I was eating vegetarian. But like, I felt something and I pulled it out and in the dim light of an Indian restaurant, like, why are they all lit like that? I was like, was this bacon, and I suddenly, you know, like, you just get this drop in your stomach and I'm like, what time is it? Four hours from now, if I, you know, 'cause there's something about it being delayed that makes it so difficult, it just is like. - Like a suspense movie with you. - It is, it's like, it could happen in the next three hours or maybe not, I don't know. I mean, honestly, the only thing that, the real reason I wanna be able to eat meat is so that I will be prepared to eat it in case of emergency. I mean, I went on a canoe trip in the Adirondex and I was like, well, what happens if I get stranded out here and like, what if I have to hunt? But I can't even eat meat, I would have to hunt fish. But then when the lake freezes over, what would I eat? I can't survive, something's wrong with me. I feel evolutionarily challenged. This is what I think about before I go to bed every night would I be able to survive if I had just what's on me right now, a pen, underwear, my dog. And so, yeah, I mean, that's a real issue is like, it's not a real issue. Obviously, it's never gonna happen in live in Brooklyn, but I do, for some reason, I always think like, I want to be prepared in case. But, yeah, you know, I don't think I would go back to eating meat necessarily. - Like you are still more frightened than game. So to speak. - Well, also like, I wish I could be a vegetarian for ethical reasons because it's not so much just the eating meat, but just like, you know, the factory farming and that kind of stuff. So I feel like morally superior now. I can be like, well, I don't eat red meat. Of course, I'm forced to not eat it, but at the same time, I would if I had the, if I had the willpower, I'd probably go that way anyway. And then also, I think it's great. It's like, we're all evolving to be on this planet, which is getting harder to be on. And we know that meat takes a lot of resources. And like, now I'm not doing that. So like, the tick is helping me evolve into a better human being. - Like so, one could, instead of thinking of the tick, as your teeny, wieny, irritating enemy, you could think of it as a guiding light, making the world safer to share with your fellow earthlings. - Yeah. - So you may have lost your relationship with meat, but at least you have your moral superiority. - Yeah, I mean, I am superior. - Yeah. (soft music) - So huge thanks to Amy Pearl for telling a story which never stopped being scary and wonderful. And to the fellow who brought her into the room, Dan Pashman, whose podcast, The Sporkful, is it's all about food in every conceivable way. Like he talks about eating it, preparing it, worrying about it, as you've heard, getting sick from it, getting fat from it, whatever. And you can find his show on iTunes, or Stitcher, or on the internet at sportful.com. And this story was produced by Annie McKeown and Matt Kilti with Reporting Help from Latif Nasser. See you next time. - All right, so that was the original piece. We're gonna take a quick break now, but when we come back, Sara and Soren are gonna follow the thread from Amy's allergy to this brand new genetically modified pig that can help a human who needs a kidney and also maybe solve Amy's problem. - Or maybe make it worse. - Stick with us. - Recording. Walking into NYU. - This building is huge. - Hello. - Hello. - All right, how are you? - I'm doing well, I don't know. Do we shake hands? I don't know, I haven't done this in a really long time. - Okay. (laughing) - Are you ready for the unreal lab? - Yeah, certainly. - Yup, everybody come one in. - Awesome. - So our update today comes to us from producer Sara Cari, who you just heard wandering the halls of NYU's Lingo and Health Hospital back in 2021. That is when we made this update. - Hello. - Hi guys. - Hello. - Hello. - This is really exciting. - As well as our executive editor, Soren. - Willie, Willie. - Wheeler. - I can give us a start if you want me to. - All right, actually, yeah. You should tell us how you even had the idea. - Yeah, I mean, I had the idea by someone else having had an idea that I saw their idea in a newspaper. - It's called reading. (laughing) - But like, I don't know, what, a month ago maybe? - I was reading the news. The news I was reading was The New York Times. - Hurtive it, hurtive it. - It was like a science section, news thing, and the article is basically announcing this big breakthrough. - News this evening about a major medical breakthrough. - It's been called an astonishing step in medicine. - Basically, a group of surgeons had managed to put a pig kidney into a human being. - Two human patients. - And it worked. - Successfully transferring a pig kidney to a human patient. - For the first time ever, the person's body didn't reject the kidney, which when you think about all the people waiting on kidneys, you know, they'll say, yeah, totally. So I'm just, I'm reading through this article, but then in the middle of it, there's just a couple lines about a particular pig that they used for this kidney that drew this very weird line back to a story we had told here on Radio Lab. That's when I, so I brought in Sarah to like report this whole thing out. - So I actually went to talk to the doctor who did this transplant. - Hi, how's it going? - Nice to meet you. How do you do? - Good, how are you? - His name is Robert Montgomery. He's at NYU Langone Health, and he's the head of transplant surgery there. - So when did it first occur to you that transplanting a pig kidney into a human would even, I just started with like the most basic question, which is like, why would you do this? - Because we don't have an adequate supply of organs for the people who need them, when they need them, and so a lot of people die waiting. And so the idea of a Zeno transplant. - And he just made the argument that using animal kidneys was the best way that he could think of to-- - Make a dent into that waiting list of 90,000 people. And do you know is this person still walking around and is the pig still walking around? - So no. - We did this transplant. And someone who had been declared brain dead, who had wanted to donate their organs, but were unable to donate their organs. And so their family essentially donated their whole body so that we could test a Zeno transplant. - Like we're gonna try this crazy thing that's never been done and see how it goes. - And determine whether this was gonna be safe to move into living humans. - I guess a proof of concept type thing. They didn't wanna-- - Yeah, so the family agreed and the doctors did the transplant and they could see that it worked and the body wasn't rejecting the kidney, the kidney was doing, it's kidney stuff. But the sort of amazing thing is-- - Actually, as we sit here today, the same thing happened yesterday. - While we were sitting there talking, he told me-- - You know, we at two in the morning, we did our second Zeno transplant. - We actually just did the second one, you wanna see? - What? - Like happening right now. - That's happening right now. And if you wanna come down with me, I'll show you what we're doing, so. - And I was like, "Oh, yes." He took me downstairs to this big room. - It's like a conference room, okay. - It was totally silent. There was like a window looking into this operating room. - Okay, can we walk up to the glass? - And you could see just like the, the jumble of machines and like medical equipment. - It would be looking, yeah. - All right, so. There's a ventilator over here. - And in the middle of the room, you could see this person. - That's the, the recipient. Lying there on the table covered by this blue surgical shroud. - You can see the patient's body kind of like rising and falling asleep. - Yeah, that's the ventilator. - And they actually attached the kidney at the person's thigh because they sort of wanna be able to watch it and they're not worried about the person getting up and walking around. So there's this incision at the thigh. And in that oval incision, you could see the pig kidney kind of like poking out. It was like covered by plastic. And Dr. Montgomery told me that, you know, when a body rejects a kidney. - The kidney will literally turn black moments after the blood goes into it. - But you could see like with this one, it was bright pink and kind of amazingly, just like the first one. - Within moments, it started to make urine, believe it or not. And so we knew right away that it was working. - Oh. - See, see right where it's dripping and see how fast it's dripping? All that urine is coming out from that kidney. - So, you know, this is just the second one that worked. But eventually Dr. Montgomery and his team wanna get to the point where they can do clinical trials on people who are walking around and doing things and living their lives and who would hold on to this kidney. - Wow. - Allow me to presume that you have two questions, which I think you do even if you haven't said them yet, which is like, one, why did this never work before? And then two, why are we even telling you this? It's not our usual stick to just pick up a New York Times science news article and relay that to you. Which brings me back to that little part of the article that piqued my interest in the beginning because the pig that they got the kidney from to do this was a very special pig. - Normally pigs and other mammals that aren't primates have a sugar in their body that our bodies don't have and so we don't like it or see it as foreign. And that's why usually an organ from another animal would get rejected. But this pig had been genetically modified. It had had the gene that makes that sugar removed so it didn't have that sugar, which is part of the reason this worked. And that sugar just so happens to be called alpha-gal. - Alpha-gal. - Alpha-gal. (all laughing) - Here it is. - Yeah. - There's the radio lab connection. - Our old friend of me. - It's really only the food that was kind of eluding us because we've known and have been also pursuing various medical device applications of the gal safe pig. We've had conversations with them. - So I actually called up the company that makes this pig. They call it the gal safe pig. The company itself is called revivicor. - Started out as the US division of the Scottish company that cloned Dolly the sheep. - The UK company that did Dolly the sheep is like they're sort of like American off-shot it. - Yeah. - Okay. - And from there we actually cloned the world's first. pigs. So anyway, I talked to David Ayers, he's the company's chief scientific officer, and also John Bianchi. Lead product development enterprises as a revivocor, and I also am in charge of regulatory affairs. So at what point, and either of you can take this, at what point did you guys realize, okay, and I just wanted to ask them like, okay, you made this pig for all of these medical transplant reasons. But did you know about the whole food side of things? I'll take this one day, unless I'm the poor sap that I had to work with the FDA. I shouldn't say that. It was a very collaborative effort with the FDA. And they told me that while they were in the middle of getting FDA approval for this pig to be used for medical reasons, they heard a certain radio show after listening to the radio lab episode, the original episode and listening to Amy Pearl, we thought, hmm, why not just expand the application to include food. We realized that the pigs that we had developed so that their organs wouldn't be rejected would also be a food source for these patients that have the Afogal allergy or the red meat allergy. Okay, wait, so hearing Amy Pearl on our show had something to do with thinking that, oh, we should make this a food product? It was absolutely a motivation of mine after listening to Amy. What? Yeah, yes. So, yeah, now because of Amy Pearl and her story, this pig is now FDA approved for medical devices and things like that and transplants, but also for food to use the meat of those pigs to make pork products that like people with Afogal syndrome can eat. Wow. So, of course, we immediately like called up Amy Pearl and we're like, Amy Pearl, Amy Pearl, Amy Pearl. We got something to tell you. Oh, my God. Always have like tiny little bundles of cuteness in your life. When we talked to her, she had a couple of really small foster kittens like scrambling up and down her shoulders and mowing in the background. So, we explained to her, you know, the whole deal, there's this pig that doesn't have Afogal that's being used for transplants from which you could make meat that would be safe to eat for people like you, Amy Pearl. That's kind of, I mean, I just, I feel kind of disgusted because it's been a long time, long time since I've had pork or beef. I've found plenty of delicious things to eat that aren't bacon. And she said that, you know, even if there is now some pork that's totally safe, she still feels sort of the same way she did at the end of the original show, which is that she's kind of just over-read me. I've kind of moved on from it, honestly. And happily it sounds. Yeah. I feel like it's better for my peace of mind. It's better for my health. It's better for the planet self. And I feel lucky and happy. It's kind of like, but then of course, you know, we had to tell her that, you know, we talked to the guys at Rivivacore and that she and her story were sort of an inspiration for this meat becoming available to people. I'll just play you a clip of something they said to me. When I heard the radio lab podcast, I'm thinking, well, we hold the hammer. Oh, God. Great. I mean, it's so fine. Oh, oh, well, but it's fine. I mean, I, I guess he sounds like such a nice guy. And say more, say more on what you feel. What's what were you thinking as you heard it? You sort of like hung your hand. I mean, I was thinking that never should have gone on radio. I don't know. Just like always thinking misanthropic things. But I was thinking like, here's a person who's like, here's me just like talking about how delicious meat is and like juices. And they're like, yeah, I love meat too. And they're like, she seems sad. I'm gonna make meat for her. And then it's like, but I actually don't really, I actually, anyway, I can make it for you. I figured it out. I have the hammer. But I actually don't want it. Okay, I'm making it. Here it is. I think she felt like because of her, they'd gone and solves this problem that she didn't even really want solved. It's just kind of like, you would go to some kind of special FDA store to buy some special genetically modified pork just so you could have a bite of some kind of meat. I mean, it just was like, I don't know. Do you guys ever get into philosophy? You ever? It just like, immediately for me when you say, oh, they created this pig that you can, that alpha gal people can eat. My next thought is like, what is the meaning of life? Why am I here? Can you, do you think you can close the gap between those two bars a little bit? Like, are there some inner meat? Because it's like, well, is that good or bad? Well, I guess it's good for people who want to eat pork, but it's bad for the pig. It just immediately brings to mind, you know, what, how to live. Do you live to satisfy your desires and and be happy? Or do you live to not harm others? Or why are we even here? Are pigs below us? Are they above us? Is it okay to put a pig first? Like, what if someone's kid is dying of kidney cancer? We'll see that. Then now, like, that's now how like, you know, this question has another whole layer because it's not just that they made a pig for people who got bit by a tick, but wish they could still have a hot dog. They also, then it turns out, made a pig that like, could maybe have a kidney that could save a life where there's no other kidney available or maybe in the future more and more and more things like that. But it's just, it's kind of like when you start thinking about breeding animals, just for organs, for people, it's like re-deciding all over again. Like, should we be eating another animal that might be intelligent? It's like, you just answering all those questions again, but for another purpose because like, you can get organs like kidneys out of other people and they're, it's like safe and. I mean, yeah, that's a good point. And I asked this guy, this doctor about this, and you know, was sort of pushing him on like, why? Like, you've just opened the door to like a whole new way of exploiting animals. And I think his thing, which I'm convinced by, honestly, is like, look, there are 90,000 people right now, right now, that need a kidney. And when it comes to like making the decision for, for yourself or like for a loved one, if you're like, they need a kidney and you're, and you have the option to put a big kidney in them, you're like, that's not even a question. You know, we eat millions of pigs anyway. I guess on balance, I feel. Okay. You know, I mean, I totally agree with you, but why don't they just, why don't they just make a fake kidney? Yeah. I mean, I mean, if somebody like, imagine humans did not think like, oh, it's okay to take to like kill an animal just to get its kidney for someone else. Yeah. It was like not even something that crossed their mind. We would have invented a plastic kidney by now, probably. So at this point in the interview, unfortunately, we actually still had one more thing that we had to tell Amy that we learned from the guys that riveted the core. I have to tell you something that you might like even less. What they named the, they named the pig Amy before they hit it with the hammer. Yeah. Yeah, they did. What? Yeah. Are you kidding? That's how you're getting? No, I'm not, I'm not kidding. By the way, the first pig that meant went to market, we named Amy. After Amy Pearl, of course. Well, I did it. Oh my gosh. I'm not sure Dave approved that name, but it did. What did they name the one who donated the kidneys? No, no, the first one that they slaughtered for me. They named Amy and unofficially, but they did. Yeah. I mean, I can see why they picked something that was like motivating for them, like humanizing and motivating and they're, they're like quest to solve this thing that they decided was a good problem to put their thoughts behind. I mean, I, it can't bother me. I can't let myself think about that poor, poor, poor, poor, living creatures that suffer. Yeah. but I do think it's good. I am grateful that like you are holding the position of making all of us think twice, including me. Like I think I've been part of the like, oh this is a breakthrough and look at the picnic and the human and the heart is beating and everything is working. It's so cool and and I do think that it's really helpful for that you're reminding me there is a cost to this that we shouldn't ignore and that you know that we should challenge our imaginations almost to imagine a world where we don't have to exploit these pigs and find another way. There could be some young budding scientists that'll listen to this version of the story and come up with an artificial kidney and name it Amy. That'd be great. That'd be great. Yeah but I think that's the only way to make this right. It's funny to think that there's like I mean how big was this pig at the end? Like usually pigs I guess when they slaughtered them for me maybe they're smaller but like I met a pig in Vermont that was like 800 pounds and I gave her a whole watermelon and to her it was like like a gum drop out. Thanks. Yeah I mean it was she was just giant. I took a hoe I was like scratching her back with a hoe and it just like looked like a little toothbrush on her and she was like oh that was so good. I mean I wonder if Amy got to be that big. 800 pound Amy. Pretty formidable. Watch out. I'm just like now wishing I could change places with her and then I'll have done my time and like I would have now be like left the mortal coil and she would be sitting here in this interview with her pig intelligence which is plenty for this probably. And you think she could raise those kittens and then she would end up on like one of those unlikely friendship calendars where it's like look at the pig raising the kittens. I wonder if there's a resemblance. What an incredible turn of events. What are you thinking? I'm just thinking about like Amy the pig going about her business you know with no thought to any of this. It's imagining like oh it's so warm here in the mud I'm gonna stay here for a little while. Well I'm hungry I'm gonna go check out the trough for a while just like that kind of that kind of living I don't know. When your brain hurts you just have to like retreat to your body. Yeah. Thank you Amy Pearl for coming on the show again and making us think more deeply than we were again. This update to the episode was reported and produced by Sara Kari and also thank you to Amy the pig. Thank you Amy the pig. Okay and finally an update to the update it is now Lulu in 2026 and back in March of 2024 surgeons transplanted a pig kidney into a living patient for the very first time. That patient was a 62-year-old man living with end-stage kidney disease his name was Rick Flamen and he lived with the kidney for about two more months before dying from heart issues which is doctor said we're unrelated to the transplant. The pig for its part was genetically edited of course but we couldn't find out any more information about its life or name. Thank you to the pig for its service. Hi I'm Gabby I'm from the Bay Area California and here are the staff credits. Radiolab is hosted by Lulu Miller and let's have Nossar. Sara and Wheeler is our executive editor. Sara Sandbach is our executive director. Our managing editor is Pat Walters. Dylan Keefe is our director of sound design. Our staff includes Jeremy Bloom, W. Harry Fortuna, David Gabel, Maria Paz Gutierrez, Sindu Nainasambundan, Matt Keelti, Mona Modgalker, Alex Niesen, Sara Kari, Natalia Ramirez, Joanna Stroghets, Anisa Vitsa, Aryan Wack, Molly Webster, and Jessica Young, with help from Gabby Santas and Maya Applebee Milamed. Our fact checkers are Diane Kelly, Emily Krieger, Natalie Middleton, Angelie Mercado, and Sophie Semyy. Hi, I'm Monica and I'm Colleen from Mexico City. Leadership Support for Radiolab Science Programming is provided by the Simon's Foundation and the John Templeton Foundation. Foundation on Support for Radiolab, what's provided by the Alfred Peace Floor on Foundation.