Worth

Hey, this is Radiolab. I'm Latif Nasser. And today, we're resurfacing a quite provocative episode we originally reported in 2014. Now, that sounds like a long time ago until you start listening and you start to realize how many parallels there are between 2014 and this moment right now. Outrageous healthcare costs, war in the Middle East, climate change. In every one of these cases, the specifics that they're referring to have changed, but the overall picture remains depressingly the same. Honestly, since it came out, I still think about these stories. I still remember them all the time, especially the last one. I would say this episode is one of my all-time top 10 Radiolab episodes. I hope you feel the same way, whether you are hearing it for the first time or hearing it for the 10th time. Here it goes. Worth. Wait, you're listening? Okay. All right. Okay. All right. You're listening to Radiolab. Radiolab. From WNYC. Rewind. Are you ready? Yes. Feeling full of worth? I'm feeling full of value. Well, in that spirit, I'm Jad Abumrad. I'm Robert Krolwich. This is Radiolab. And today. Three very different stories that try to put a dollar value. Mugen. It's okay. One million dollar. Seven dollars. Ten thousand dollars. Yeah, I would say five bucks. On things. That seem. Priceless. Priceless. Priceless. Priceless. Is it really? Okay, so start at the top. Bring on the pressure. So tell. All right, we're going to start the show with a story from our producer, Molly Webster. I don't remember any of it. Who we might actually want to rename Molly Wongster, because she recently got herself some serious numericizing. Actually, it didn't start. As a wonky thing, it started actually with some medical journals. Yeah, it was. So that was. That was interesting, because it was some of the most poetic writing I've seen out of doctors ever. One journal article said, like, what would one more month mean to a 37-year-old mother who has four children? Or what would one more month mean if you are a 67-year-old who's about to go traveling around the world? People were just kind of, like, drifting these questions. All these questions seem to circle around a seemingly simple story of the pricing of a drug, a cancer drug. And the story, if you really want to tell it from the beginning, it begins with this guy named Leonard. Leonard Saltz. I'm a medical oncologist at Memorial Sloan Kettering Cancer Center. Which is here in New York, and it's one of the largest cancer centers in the country. I mean, we have 17 doctors here who treat colon cancer. Just for colon cancer. We treat a very large number of patients. It's a huge hospital. And one of the things Leonard's been noticing in the last, I don't know, decade, is cancer drug prices have just gone through the roof. I mean, we have drugs out there that are many hundreds of dollars per pill. Really? Yeah. Oh, just wait. Let's see. Where does this start? It starts, it's June in 2012. Leonard Saltz is at a conference, and at this conference is a pharmaceutical company called Sanofi. And they give a presentation about a new drug that they have. A drug called Zaltrap. And Zaltrap is. Zaltrap is a drug that, without getting into the science too much, targets the blood supply to the tumor. It cuts off the blood supply, which means the tumor can't grow. That's the scientific hypothesis. So this new drug is presented, and they, like, present the data. And they showed that the survival difference. Between the people who got Zaltrap and the people who didn't. Was 1.4 months, or 42 days. In other words, if you take this drug, you could get 42 more days of life, on average, which means you could get three more days, you could get no days, you could get 42, or you could live another three years. Forty-two. Forty-two days. Down to the. Down to the fine grain. Yeah. Oh, please. I could show you some graphs that have been put up at meetings that show survival curves calculated out to two decimal places in terms of months. So I'm looking at the. So that's, like, not a tenth of a month. A hundredth of a month. That's a little over seven hours. What? Pretty amusing, actually. Why would you. Why would you. It's called pseudo-precision. Pseudo-precision. At any rate. Anyways, after the conference, the FDA approves the drug, and basically, once the FDA approves the drug, public insurance has to take it, and then the private insurance companies just follow suit, which means you get prescribed the drug, and people pay for it. And what does the drug cost? That's the thing. It costs. Roughly. $30,000 for a three-month course. Wow. So. So Leonard's like, "Wow, that is expensive." And. There was already. Another drug on the market did the same thing, and it cost half as much. To put that in context, this is just one drug that's $11,000 a month. A normal cancer patient might take dozens of drugs. There are anti-nausea medicines that are sometimes used that are in the range of $90 to $100 a tablet, and you take a tablet once a day for three days. One needs growth factors to help support the white blood cell count, which you sometimes need in chemo. Those can be $5,000 every two to three weeks. If you need antibiotics. To treat infections, those aren't cheap. And then you need a pharmacist to prepare it. They're labor-intensive. You need tubing and equipment and needles to give it. You need trained nurses to administer it. You need doctors to take care of the patients. And don't forget there's a cost for a CAT scan or MRI. And then, of course, someone's got to pay for the real estate, the heat, and the lights. None of those prices are figured into it. Okay? I'm just giving you the cost of the drug. So Leonard calls up one of his colleagues. My name is Peter Bach. I'm a physician at Memorial Sloan Kettering. Peter is the number cruncher of the group. He does the statistical analysis of, I don't know, the cost of care. And Len grabbed him and ran him through all the data. And we walked through the out-of-pocket expenses for Medicare beneficiaries. Medicare beneficiaries, if they don't have additional insurance, 20 cents of every dollar they pay out-of-pocket. And that number sort of hit him because he realized for Medicare patients, they'd be paying something like $2,000 out-of-pocket every month for just this drug. $2,200, if I remember the number correctly. For a lot of Medicare patients. That's all of their money. Never mind other drugs. That's when I thought we should go public with it. Memorial Sloan Kettering, they decide to boycott this drug. Now, that. Is that. I mean, I'm just stopping you because when you guys made that decision, was that. That feels like a big deal. It did feel like a big deal, and it felt like a big enough deal that we decided to write the op-ed piece in the New York Times. They write an op-ed in the Times that basically says, "Look, this is crazy. $11,000 a month for a drug that maybe gives you 42 more days of life?" Is that worth it? And a little less than a month after the op-ed piece came out. The company that makes Altrap. They went to individual doctors' offices, sent representatives, and said, "We are offering a 50% discount." They cut the price in half just like that? Yep. Nationwide or, like, just in this area? Nationwide. It was sort of incredible. We reached out to Sanofi to talk about the price of Zaltrap, and they declined to comment. But in a statement that they released when this whole Zaltrap thing happened, they said that they incur so many costs for researching and developing and bringing a drug to market that that is what their pricing is based on. Leonard doesn't disagree. We need these companies. They're the ones developing the drugs. Which aren't easy to develop. I mean. There's one example. If we talk about colon cancer. He says for years there was only one drug on the market called 5-FU. 5-FU was patented in August of 1957. It was from 1957 until 1996 that a second drug came along. That's how long it takes to develop a good drug? Or. In that interim, there were over 70 drugs that were tried and failed. I feel like I don't give it enough credit because that just astounded me. It's very, very hard. And that, according to Leonard. It's one of the reasons why prices are just going to keep going up. But sooner or later, this system is going to fall apart. And at what point does society say there isn't an infinite number of dollars that we can commit to our health care system? It's funny because I had this interesting reaction to the word "society." Because all of a sudden I thought, like, why is. Not in like a, you know, crazy death panel way. But I thought, why? Why is. Why is society involved in my conversation with my doctor about if I want to take this drug that may give me another month and a half of life? Why is society involved? Because you're not paying. Unless you have hidden resources I'm aware of, probably couldn't afford 10 to 15 thousand dollars a month in drug bills. Someone else has to pay that. Obviously, he says, it's your insurance. I mean, say you're part of a policy that has 1,000 members. Let's say that the premium for that is 100 dollars. So we got 100 dollars, 1,000 people, we got ourselves 100,000 dollars, okay? So we now have 100,000 dollars to take care of that 1,000 people. For that month. For whatever amount of time. If now one person comes up with a health care cost, let's say it's for a month, that is 100,000 dollars in that month, everybody else is in trouble. There's no money left. So, they write this op-ed saying, like, prices are too high and the drugs are not that great and sort of the next like notable wave is um there was this there's this journal called blood which is really big to anybody that works in a community it's a journal called blood yeah how did we not know about this when we made the blood show oh i knew just kept it in here anyhow um so yes there's a journal called blood which is basically like the the journal for anybody that works in a field that has to do with blood and what happens is like a hundred doctors get together and they co-sign an editorial which basically says we totally agree with everything you guys are saying but we have an even bigger issue you know with zaltrap you're talking about an expensive drug that maybe doesn't really do that much it's kind of easy even though it had never been done before to say we're not going to use this what all these doctors in the blood editorial are saying what do you do when you have a really expensive drug but it's really really good it's like a drug you actually want to take is is that like a like a one day in the future we will face this kind of question no that is like a now today question the most important new medicine approved this year everyone i talked to pointed me to this new drug called solvaldi it's known as sovaldi sovaldi many in the medical community are calling the new medication a blockbuster sovaldi came on the market last december so that's december 2013 that's correct this is bruce bruce moll i'm the editor of commonwealth magazine he's written about sovaldi and here's the basic story right it is a drug that treats hepatitis c which is caused by a virus and the disease itself goes to work on your liver it inflames it it scars it it can cause liver cancer cirrhosis it can be fatal and for the longest time the treatments that they had just really weren't that great or they just had wretched side effects but along comes sovaldi and it's one pill 12 weeks you take it with some other antiviral meds it is a super simple treatment option and the side effects are very minimal like this it was like kind of like the savior drug and so a lot of doctors start to prescribe it in the first half of 2014 70 000 people in the country in the united states were treated and it had a 95 percent rate of cure in other words the virus was eradicated that's very big but in fitting with our story this drug costs a thousand dollars a pill for like one one pill that i take one a day which as you can imagine it angered a lot of people with hep c in total it costs 84 000 and if you think about the fact that in 2014 we know at least 70 000 people got this drug then you're starting to talk about serious money wait i'm i want to i i just want to say that i that i i just times doubt 70 000 times 84 000 and i got something with seven zeros in it it's five eight eight and then there's seven zeros which is like a bit five billion dollars yes yeah the big question is how states will pay for what could be upwards of and so we have a situation where states are buying drugs and they're buying drugs and they're basically having to ration yeah say in massachusetts most of the insurers currently are requiring some liver damage before you can take the drug similar restrictions are happening in other states florida it's happening in oregon illinois the doctor says the only option may be to wait until you're even sicker and then there's arizona out of the entire state public insurance only approves 180 people for treatment well it's just 180 just 180 now when i talk about the to a representative of the company that makes the drug. Greg Alton, Executive Vice President for Corporate and Medical Affairs for Gillette Sciences. He says, you got to keep in mind, this is not a chronic care situation. This is a. Cure. Here, you're actually curing a person of a disease. We're talking about 12 weeks of therapy, period. That's it. And you're done and you've cured somebody. So he says, this is a one-time deal. This is like one-time $84,000. And then you're done. Think about all the years you'll live without having an illness. Then you'll see. Over a 20-year period, the savings that will accrue to the system by having a patient cured of hepatitis C. He also said, it's important to understand that every hepatitis C sufferer is not going to hit the system at the same time. So all of the cost is spread out, right? Which is totally true. But I think there's like this bigger picture here. And Bruce points it out too. It's sort of like a precursor of what could come because these companies are developing drugs all the time. What if you could get a drug, but it was very expensive to treat diabetes? And then you're talking tens of millions of people. An enormous segment of the population. Even if just a fraction of them want a drug that's $1,000 per day, that's practically our entire U.S. budget. What do you do in that case? A drug comes along like that and throws everything out of whack. This is the part where I really sort of got hooked in, where it's like, how do you answer this question? Is it that at a certain point, you just draw a line and you say, beyond this point, we're not paying. But beyond what point? Exactly. I mean, that's the hard part. Like, how good does a treatment have to be for you to say, this is worth the price that it's been set at? I don't think we reject it out of hand, but I don't think. I got into this a bit with Leonard. In the case of Zaltrap, they said, all right, 42 days, that much money, we're not going to do it. But would it have been different if it was 50 days? Or 100? Is that enough? I'm sure you want to be talking in years, but I guess the question is, like, what would be, is there a magic line for you? If I, this is a, I can't personally determine it for everybody. I wouldn't presume to try. But ultimately, as a society, we're going to have to reach an understanding of what that cut point is. Because we can't afford not to. And the question that's sort of, bubbles out of this conversation is, what is one more year, or one more month, or one more day of life worth to us? Are we willing to pay $1,000 for an extra day of life? Well, what about $100,000 for an extra day of life? You know, people like to say, yeah, so what's the value of a human life? And the answer is, boy, that's a complicated question, but a really important one. Because nobody thinks it's infinite. He said that, and I was like, okay, it's not zero, and it's not infinite. Is there an answer, like, in the middle? And so I started looking around. I don't know, I guess I was wondering, has anyone actually thought about this? And so I started looking around, and what I realized was that the World Health Organization actually, I mean, I guess they almost have a number, but it's a number per country. They have the recommendation that countries spend, it's going to get gobbledygookie, but just bear with me, that countries spend one to three times the GDP per capita, which is like the gross domestic product. So take the entire fat ball of money that is in a country and divide it per individual? Divide it by the individuals, and then you spend one to three times that on one more good year of life. And what would that be for us? So for the U.S., that's about $50,000 to $150,000. Interesting. And does that have any teeth, that recommendation? It legally doesn't have any teeth, but it has teeth in the sense that doctors in the U.S. are actually going to start using. Yeah. This WHO number to evaluate medical treatments for cardiology. They said they were going to do this in a paper, and it was kind of very quiet, very subtle. But in other countries, this conversation is very loud, actually. It happens at the government level. They're also passing out surveys where they're asking citizens, what is your limit on how much you want to spend on one more good year of life? Have they done that here, ever? As far as I know, no. Why not? Because the last time we tried to talk about cost in medicine, it ended up in the whole death panels or so-called death panels thing. And I don't know. I just wondered into the mess of it. Hey, Times Square. If I actually tried to go out and ask this question in a very basic way, how would people respond? Excuse me. Can I ask you a question? What is a year of life worth? Wow, what a question. That's deep. Can I think about it? That's a tough one, but. I was really surprised at how seriously people took the question. Man, what is a year of life worth? That was the first thing I noticed. Then the next thing was, no one could answer the question until I had answered like a million questions of theirs. Am I going to die tomorrow? Yes. Where do I get that year? Do I get it at the beginning, the middle, or the end? How would I spend that year of life? Good. It would be a good year of life. A good year of life depends on. Is this like a. They wanted to know, would they be emotionally happy, alone, with friends or family? Where did they get the money? Could they borrow the money? Did they have to pay the money back? Were they dying? Was it an emergency? Were other people also trying to get money at the same time? Because then there'd be like a rush on the money in America. Oh, interesting. Did you actually ever end up getting numbers? I did get numbers, but they were. At least $10,000. $15,000. $13? Quarter million? $7. All over the place. Yeah, I would say $5. $10 million. Eh. $44,000. dollars interesting one woman said 10 million 10 million dollars for a year it's irresponsible well you're asking me about my personal choice 10 million dollars not about a public policy question what do you have any way of parsing all this no i really i honestly don't like i think my biggest takeaway was like no one punched me which which makes me feel as if people are ready not ready but willing to engage in this conversation but i also realized i kept talking about things and i just wanted to be in the room with patients like i just wanted patients in the room with me because it was like we were all having this conversation that eventually we'll all be patients i guess but we were also having this conversation around like a group of people that weren't ever present like they're not at conferences or not in research articles and so that was when i started talking to patients ah you well i guess what is 42 days what does 42 days mean in the sense of is that something that you'd pay fifty thousand dollars for if you were i mean of course you would that it's like no i almost can't even ask the question but i don't know i know i think it's a good question i think ethically it would be to the good of patients and doctors to have this conversation this is susan susan gubar writer of the living with cancer blog for the new york times back in 2008 susan went to the doctor she hadn't been feeling well for a while they thought it was some sort of bowel issue but then the doctor walked into the room and said she had advanced stage ovarian cancer most ovarian cancers are diagnosed at a late stage and um it's it's basically incurable it can be handled it can be managed that it can be kept at bay and for longer periods of time it can be managed and it can be done in periods of time now we hope but you're given a diagnosis of three to five years wow that is you go from having unlimited time in your mind to three to five years in like a doctor's visit yeah it's it's it's a big shock you sort of enter a zone well you're not quite aware of what you're doing that day the day she was diagnosed she was told pack a bag get in a car and drive to indianapolis you need surgery now so i went the next day to indianapolis and the day after that i had the debulking surgery which takes out the ovaries and the uterus and the fallopian tubes and the spleen and sometimes the cervix and sometimes the appendix and holy sometimes the bowel and are you serious yeah it's called the mother of all surgeries and then just like that she was doing multiple rounds of chemo chemicals that are used uh they destroy all quick growing cells so for example you have no hair no eyebrows no eyelashes that you know uh you you also can i got terrible sores in my mouth i have no idea why but i i know this happens to other people but yeah the other thing is this extreme fatigue and susan who writes for a living couldn't even read i would look at a page and think had i turned a page chemotherapy it really is toxic to the spirit to the heart to the mind just the normal aspects of life feel polluted have you ever had to think about cost i was never informed of the cost of any drug or any procedure i was given which really makes me think about how masked these costs are would you want to be thinking about cost while you're going through it or is it better to just say here are your treatment options these are statistical outcomes like pick one and then we'll deal with it on the other side i think there's a kind of unspoken agreement among everyone that the insurance company or medicare is going to pay and if it's the government that means our grandchildren are going to end up paying for all of this money so yes i guess to answer your question i think it would be healthier to know what these things cost on the other hand i have to say as a patient i would say yes i would be healthier to know what these things cost on the other hand i was so traumatized, I'm not sure I could have taken that information in. I was thinking about your what it's worth, what's it worth title, and I was thinking that the American individualistic, optimistic response would be, well, whatever it takes. Whatever it takes. Life is worth it. Whatever it takes. But whatever it takes will not cure my cancer. So I think this question changes when you have incurable cancer. It becomes a different question, which is, when is enough enough? I remember when she said that, when is enough enough? I was just. I don't know that we are ready to say there's one magic line. Thrown back to this conversation that I had with Leonard Saltz, where he. He was saying that. We have to look at everything in terms of value. You need to think deeply about the kind of life you want to live. It's not just about how many days. It's about what kind of days. So if you told me that there was something that gave 72 days survival benefit, but it makes people feel nauseous for most of the time, is that worth it? When we're trying to draw this line as a society, before we figure out what we're willing to pay, we have to think about what we. We are paying for. Yeah, I don't think we know what. For Susan, you know, six years ago, she decided that she was going to get chemotherapy because, in part, it would be more time with her daughters. Yeah. And suddenly, it's worth it. Yeah. But I think we're changed by the treatment, too. For now, Susan's cancer is basically under control because she's on this new drug. For two years, and now a month. I am counting. Okay. Fair. I've been alive without a recurrence, without the cancer growing, by taking these pills every day. Mm-hmm. And I take them at home. They're not infused in the hospital through my veins. They're just pills. And it's made the last few years remarkably normal-like. The new normal. Yeah. But when these drugs. Stop working, and I've been told they will stop working, I'm not sure I would want to go back to chemotherapy. But I suspect I don't know until I get there. Yeah. But I don't know until I get to the end of my life, I don't know until I get to the end of my life, I don't know until I get to the end of my life, I don't know until I get to the end of my life. I don't know until I get to the end of my life, I don't know until I get to the end of my life, I don't know until I get to the end of my life. And to Glenn Blomquist. Radiolab will continue in a moment. 3, 2, 1, hey, I'm Jad Abumrad. I'm Robert Krolwich. This is Radiolab, and today. Well, we're still on the subject of worth, but this is a totally different take. Yeah, and this comes from our producer, Matt Kielty. So, next, a slightly different story about worth. A story that, rather than being about how much we value our own lives, is about how much we value someone else's. Right. And it starts with BuzzFeed writer Gregory Johnson. So, okay, maybe you should start with what has now become sort of the infamous wedding drone strike. Right. Was that sort of where it started for you? Yeah, so this strike happens in a very rugged part of Yemen, where there are no paved roads, no electricity, there's no running water. It's Thursday morning. December 12, 2013. Early that morning, in a small village. A group of guys, roughly 50 to 60 people. Including a soon-to-be-married man. Allen knew a bunch of cars, and they started driving. This is the convoy. The wedding convoy. Now, in the lead car of this convoy was this man. His name is Abdullah Mohamed Al-Taisi. We spoke to him through an interpreter in Yemen. And Abdullah told me it was his neighbor who was the groom to be married that day. And so, they were all driving up to the bride's village. Abdullah said they got there a little before noon. Ate lunch, recited wedding poems. After lunch. They grabbed the bride. And just a few of her bridal attendants, a few females. And they start driving back to the groom's village for the actual wedding ceremony. Now, Abdullah said that ever since they'd left that morning, through lunch, all day long, they heard this humming. This sort of metallic whirring, this metallic thumping overhead. No one in the convoy could see it, but they knew what it was. A drone. It's nothing new for people in rural parts of Yemen by this point. They don't think anything of it. It's common to hear those sounds. Yeah, it's usually heard there. So, they keep driving. Basically, if you can imagine it, they're sort of winding through these wadis, these desert, mountainous places. They're all strung out on this rutted out little dirt track. 11 cars, single file. Finally, they reach this little clearing. Up near the top of this cliff, where they all slowed down and started to bunch together. Because apparently, one of the cars had gotten a flat. Some guys got out, fixed it, got back in their cars. Then right at that moment. The sound shifts. Somehow. And then. The missiles start. Four of them. In quick succession. The shrapnel is just flying everywhere. In a blink, it's over. People are trying to figure out what has happened. All the screaming. There's fires that are burning. And Abdullah. His car was torn up. He had shrapnel in his face. Two wounds in his face. One in the right hand. In the right hand. Left thigh. One in the back. And he says that once he saw there was smoke, his first thought was, where's my son? He was looking for his son. His son was there? Yeah, a young man who'd been a few cars back from him. He had the fourth car on the convoy. And he was married with two boys and one daughter. Abdullah said he could move, so he got out of his car and stumbled back toward the fourth car. To find his son. Yeah, he said he found him just next to the car. Before just he. He died. No, he didn't talk to him. Just he looked at him and just. Passed away. So, it turns out that there are 12 victims. There are 12 dead. And typically what happens in Yemen is that as soon as someone is killed, they're buried very, very shortly thereafter. What happens here is something different. The people in the convoy take the bodies of the dead. And they take them back to Reda. This big town where the drone strike occurred. There's a video I have. That's what you're hearing, where you see some men take these 12 dead bodies. And they line them up in the street on this bright blue. Blue tarp. And they sort of wrap them in these cheap blankets. And so, there's this huge crowd that just gathers around to stare at these dead bodies who are laid out in the street. And at a certain point. This very tiny, very leathery old Yemeni who's sort of holding on to the back of a pickup with one arm. He stands over the dead. Sort of swaying over the bodies and just lecturing the crowd on what happened. And he's just screaming at them. And so. You can hear his voice start to go hoarse. And he's screaming, an American drone killed these. It was a massacre. These people are on their way to a wedding. Why did this happen? Why were they killed? Why did they target this convoy? Well, according to the U.S. government, they had received intel that on that day, in this convoy, was an al-Qaeda operative. Named Shauky al-Baddani. Who apparently had been planning attacks against the U.S. That's why they took the shot. And in fact, they say that he was wounded in this wedding convoy strike. And do we have any reason to believe that? I have no reason to believe it. Greg spent weeks in Yemen, talked to survivors of the drone strike. Talked to people who were there. No one knows this guy. And Greg says the guy isn't really a member of either of the tribes that were involved in the wedding. And so, to him. It makes no sense that he would be there. To him, this was a terrible mistake. But what really got me interested in Greg's reporting, which you can read on BuzzFeed.com, highly recommend it, is that he goes really deep into the question of, like, what the U.S. did next. Because the question is, like, what do you do in this case? How do you repair it? How do you repair something like this? When you have two totally different cultures with two different traditions, how do you find a way to try to make this right? Can you? I mean, historically, do soldiers have an obligation to repair the damage they do? No. There's no obligation. But what's happened is we've actually created an obligation for ourselves. Americans have? Yeah, yeah. This has a really long history. A history that's. You mean, like, legally? Yeah, yeah, yeah. A legal history. Really? And there's a great law professor at Yale. What's his name? His last name is Witt. It's John Witt. That's me. We ended up tracking down John Witt. Hi, Jed. How are you?. to talk about how the U.S. first started to try to right their wrongs in war. So what is the foundation story of all this? That starts with General Pershing in World War I. So, 1917. It's called to arms. The Great War ramps up, so we start shipping young men. Thousands of them, and millions more to follow. over to Europe. We'll be over, we're coming over. Specifically, France. And in charge of these men was a man named John J. Pershing is the. Commander of American forces on the Western Front. Stern man. Handsome mustache. Bit of a maverick. General Pershing's nickname was Black Jack, and. When he first arrives in France with his troops, General Black Jack Pershing. He's got this problem, which is that he has Jeeps. built in America. built in America, shipped to France, and manned by our men. So, World War I is the first war in which the U.S. is shipping a lot of automobiles. More than 100,000. For the soldiers to drive cars, trucks, Jeeps. And Jeeps are really great. They get his men from one place to another. From Paris, to Amiens, to, I don't know, Marseille. But they also run into French farmers' chickens and cows, children, sometimes just the farmers themselves. Were these random collisions? Or were there no roads? I'm going to bet. There was some of everything. Sometimes it was probably just ordinary car accidents. And sometimes, no doubt, a little French wine was involved. So, this is Pershing's problem. He's trying to run a war. Overseas. And it wasn't any good for him to have grumpy civilians at his rear. And so, Pershing has an idea, which he actually borrows from the Brits. And that is, he will use. Cash. money to right our wrongs. Well, and so he goes to Congress and begs for a statute. And Congress obliges really quickly. There's no sign this is a controversial thing. But it was a genuinely new thing. Because for the first time in the history of war, as far as we could tell, you had a state compensating individuals. Usually it's state to state. Here you have state to individuals. And so the U.S. government starts systematically paying money for the loss of a non-American life in war. How much? Jeez, I don't know. It's actually surprisingly hard to find documentation mentioning specific amounts. But whatever the amounts were, it seems to have worked. We're gonna square up. Pershing wrote in his biography that the swift and prompt settlement of claims had a great effect upon the people. So it seemed to work really well. And is this, I mean, is the idea here that, like, this is what we would do with the drone strike victims we talked about? That we'd pay them money? Well, it's actually, it's a bit trickier than that. Because the thing that Pershing got in World War I, it came with a catch. And that is that there's a combat exclusion. In case you just walked in, that's Gregory Johnson. And what he means is that this law, basically what it said is that we'll pay your claims if it didn't happen on the field of battle and it wasn't a combat situation. If it was combat and it was on the field of battle, then tough luck. That's just war. So if U.S. soldiers were driving to a fight and they ran their car into somebody and they damaged that car or killed that person, those people would not be able to get compensation. Whereas if the U.S. soldiers were driving to a ballroom, a bar, and got in an accident, they would be able to get compensation. But the problem is, once we get into these counterinsurgency wars, civilians are suddenly in the middle of the fray. Charges have been made that troops killed as many as 567 South Vietnamese civilians during a sweep. This is, in a way, the story of modern warfare. Air raid sirens are beginning to sound over Baghdad. President Karzai says he's delivering his final warning to the U.S. after a U.S. airstrike accidentally killed more than a dozen mothers and children. By the time we get to Afghanistan and Iraq, the fighting is happening in cities. So there's no difference, really, between the battlefield and where people live. And so the line between what's combat related and what's not combat related, it starts to get blurry. And so in 2003 in Iraq, what happened was there were actually people lining up. You know, there were civilian military operations centers. People started lining up outside of these saying, my family has been harmed. I want help. How many people do you remember? If I had to guess, it was, you know, maybe around 80 people or so. That's a ton of people. Yeah. That's John Tracy. He was a military lawyer in Iraq in 2003. And before him, Marla Keenan. I'm managing director of Center for Civilians in Conflict. So when they came with a complaint, what sort? Is it like you ran over my chicken or you knocked out my window? No, no, no, no. Much more serious. I mean, I think of cluster bombs during the Shock and Awe campaign. One of the types of bombs that we use, of bombs that we were using, or the Air Force was using, what they call cluster munitions. Basically, John says, Air Force planes would fly over these targets and drop hundreds and hundreds of these tiny little bombs smaller than a Coke can. And a lot of them would land in maybe a parking lot or a field, and they wouldn't explode. So, on a number of occasions, you'd have mostly it was kids, right? Because the kids would see it, and they didn't know any better. They would just run over and kick it, and then that's when it would explode. That's when it would detonate. Right. I had a lot of those, close to a dozen. And so, that was a difficult one because well, it's combat because the Air Force dropped it because they were, you know, bombing the city. Right. But, at the same time, days, weeks, even months have gone by and this thing is just sitting in the ground. Couldn't we say it's not combat? And this was a real question that John had to ask his boss, and then his boss asked his boss. They eventually sent the question up to the Army Claims Service and they said, no, it's combat. Meaning, they're not going to pay. Basically, like, we are in an armed conflict, and this was an unfortunate incident, but an incident that happened during a lawful combat operation, and therefore we're sorry. And that's basically it. So, I said no to a lot of people. And so, like in World War I with General Pershing, military officers they started lobbying their bosses for an expanded system so they could start making more payments. And eventually, the military does expand it. In fact, I talked to one of the military's top lawyers. Brigadier General Richard C. Gross. I go by Rich. I'm the legal counsel to the chairman of the Joint Chiefs of Staff. And he told me that around 2006, paying out these kinds of condolence payments actually became sort of a key part of military strategy. Absolutely. Even had its own acronym. MAWS. M-A-A-W-S. It's Money as a Weapons System, which you know, I'm not sure that title resonates with everybody. Interesting phrase, for sure. Yeah, exactly. But it's the idea that money can be used to win hearts and minds that help bring the population over. And it just got me wondering how much money makes a good weapon? Well, I haven't, like the U.S. military hasn't given me access to a database or anything like that. But through FOIAs and interviews I've seen different numbers. Marla says that in 2006, the ACLU filed a FOIA request and eventually got their hands on hundreds of claims files. And in those files, what you see are a bunch of different numbers. But one that comes up again and again, $2,500. $2,500 by and large. Now, someone like John could have paid more, but that meant they'd have to run the claim up the chain of command. Exactly. So it was almost like there were these ceilings. $2,500 for a life, $1,500 for property damage. And then eventually the property damage amount got raised to $2,500 as well. And that didn't make any sense to me. That somebody could get so much for a Toyota Corolla, but you were just going to get the same amount for a lost life. Like, I can't get over I mean, $2,500 seems like just such a nominal amount. And the practicality of that money, of like, if you were to kill someone who is the breadwinner of a family, that $2,500 would not be able to support this family in any way. Right. But we're not actually trying to pay full compensation, right? Like, we're not trying to say, we think if this 20-year-old man had lived to be the average age in Afghanistan, that he, you know, that it would have been $60,843. Right? Like, that's not the thing. You know, we had people who were killed here in an attack. The federal government is one step closer to cutting its first checks to families of those killed and injured on September 11th. And those people have been compensated. The levels of compensation to the New York victims is pretty high. The range of payments for a death claim ranged anywhere from $250,000 to just under $7 million. Do you notice that? I do. I do. But it is to a large degree comparing apples and oranges. That's General Gross again. Because you're talking about a legal system where a country is paying their own victims versus condolences in an area where there's no legal obligation to make those payments in the first place. So, that's a very different type of monetary payment. Well, yes and no. Essentially, it's a person's life. And, I mean, I think there's an argument to be made that there's an empathy in the number that you come up with in the amount that you pay for someone's life. I totally get what you're saying. The $2,500, I think it's any amount of money. If I told you $10, would you feel better about it? I'd feel a little bit better. You would? I think so. $10? What does it get you, though? In the end, $10,000 doesn't buy anything more back than what you lost. I don't know what $10,000 gets you exactly in Afghanistan, but my assumption is that it gets you a lot more than $2,500. But does that really help you? Is that really what you want? Is the money unimportant to you, really? It sounds like the money's really. I'm not a victim, so I don't know that I can answer that. To me, if it happened. And at this point, Marla told us a story about how, before she got into this line of work. I had several friends who were journalists. One of those friends was a man. He was a man named Chris Hondros. Yeah, he's a photojournalist. He was a photojournalist. And back in 2011, Chris was on assignment in Libya, moving with a rebel group when they were fired upon, and Chris was killed. Yeah. And Marla says when she found out that happened. I wanted someone to explain to me why that happened. I mean. Sorry. I just wanted someone to explain. I didn't. You know, like, I knew his family wasn't going to get any money. I knew that. These guys that shot a rocket propel grenade at him weren't going to care. No one was going to explain. But I wanted that. And the money then becomes an occasion for you to say, like, not just, I'm sorry, but here's what happened. It's the here's what happened part. I think it's the token that's given with the apology and with the explanation. But it's the apology and the explanation that matter to you. Yeah, that's why we call it amends. Making amends. Making amends. One of the things that is true of money damages, generally, is there are desperate effort to find some common language between the party paying and the victim. Some Esperanto for communicating the meaning of what's happened in a language that the other side knows matters. That's how John Witt puts it. Because we see it everywhere we look. We see not just apologies, sometimes not apologies at all, but we see the almighty dollar, which is both distressing and also we know it's meaningful. But the problem is, in order for that Esperanto to work, it has to say the same meaning to both sides. Which for John Tracy, wasn't really about the money at all. Or not just about the money. It was as much about the envelope that the money was in. Or that there was a lot of money in it. Or that there was a real person there to hand it to them. I wasn't the one who raided their house. I wasn't the one who killed their daughter. But most of them, they, you know, just wanted to look at somebody who's in a uniform and say, you really messed with my life. And that opportunity is exactly what Abdullah Al-Taisi will never get. His son was killed by a drone he never saw, operated by a man he'll never meet, on behalf of a country that still doesn't admit it was a mistake. And so the money he got, which in the end he says was the equivalent of 30,000 U.S. dollars, way more than anyone got in Iraq or Afghanistan. Still, all he can do, without anything else to go on, is just compare amounts. I can accept that only if, if, if, if he gets, you know, like the payment equal to those, you know, to like in America, how you can say someone who, who lost his son, for example, killed. If the payment was, if the payment was equal. Yeah. If the payment was equal, you know, for the person who lost his son, for example, you know, for the person who lost his son. I think that's one of the interviews that we didn't think he could get. Yeah, absolutely. Thank you to him. Coming up. That's next. Okay, now it's my left ear. Hello, Zoran, how are you? Good, how are you doing? I'm good. Hey, I'm Chad Abumrad. I'm Robert Kroll. This is Radio Lab, and so far we've been talking about the value of our lives. And then the value of other people's lives. Next up. The value of. Everything. All of it. Everything. Everything. Thing. And by everything, of course, we mean. The value of nature. That's Carl Zimmer, science writer, regular blower of minds. So we think of ecosystems as just kind of sitting there, but actually they're doing things. If they weren't doing them for us, we would have to pay to do them artificially. For example, cotton farms in South Texas. So, you know, the farmers are doing their thing. Like this guy. James Parker. Planting their cotton, they're collecting it. I farmed about, I don't know, usually five to six, seven hundred acres of cotton. So say two thousand bales. They're doing what farmers do. I spend a lot of time on a tractor and you have to check your water every morning, every evening. Meanwhile, they have all this extra help in the air. Yes. They have bats. How many bats are out there, you really don't know. Flying all around. The bats eat the equivalent of two-thirds of their own weight in insects. Every night. Wow. They eat all night long. All kind of bugs. A whole bunch of pests that would otherwise be eating the cotton. Now, a few years ago, a guy named John Westfall did a calculation just to see how this arrangement was working out. He came out to my farm and did a study. He had some college girls that worked for him and those girls were out there all hours of the night listening to what the bats were saying. Each year, the farmers, collectively, they make about four or five million dollars off of these bugs. They make about five million dollars off of these farms. The question was, how much of this is because of the bats? Because, you know, bats are natural pesticides. You know, the more they're eating, the less I've got to spray. And here's what the scientists figured out. Out of four to five million dollars, it was around $700,000 that you could ascribe to the bats. It's just beautiful. Wow. I mean, it does make me think that if you're those farmers, you should be compensating the bats somehow. Yeah. Well, yeah. It does give you a glimpse. It gives us a glimpse at the kind of scale of value, economic value, that nature has that we generally just totally ignore. But we talked to a guy who didn't ignore it. My name is Robert Costanza. In fact, he took this way of thinking to the absolute limit. Yes. So the question was, what's the value of all of these ecosystem services globally? All the services on Earth. You know, it's bugs eating leaves. Worms turning the soil. Beetles chewing tree stumps. Coral reefs protecting cities during storms. Everything. We tried to synthesize all of the studies that had been done around the country and the world. Like that bat study. Except they didn't just look at cotton farms. They looked at. Tropical forests. Rivers and lakes. Coral reefs. Coastal wetlands. Inland wetlands. The ocean. Woodlands. Temperate forests. You know, it goes on and on. Grasslands. This must be some Excel spreadsheet. It's kind of the Excel spreadsheet from hell. It can get tricky. So Costanza and his colleagues took all these different studies, summed them together, did a whole bunch of math, and. Came up with a number, which in today's dollars is a hundred and forty two point seven trillion dollars per year of services. And that's more than all of the gross national products of the world. Well, that's how valuable the services of nature are. Yeah, let me ask you, like, I get I get the way this would work with a bat, like the bats eating the bugs, but like, how do you do it with like, with like a like a field or something like, do you just walk through and you're like, oh, that's 20 bucks of services. That's 50. Like, how do you even figure out what the services are? Well, they they came up with a list. So the list kind of depends on the ecosystem you're talking about, because different ecosystems provide different services. For example, a salt marsh. And we are in the water. We're in the water. What is a salt marsh? Is it like the Florida wetlands, but salty? I suddenly don't know what a salt marsh is. Salt marshes are wetlands that are on the coast. Got it. Yep. We're standing in about a foot of water here. We're quickly approaching high tide. We sent one of our producers, Simon Adler, to a nearby salt marsh. Partially to haze him. Your boots are much more waterproof. Yeah. But really, to talk to this guy. My name is Adam Welchel, and I'm the director of science for the Nature Conservancy here in Connecticut. And Adam gave Simon a kind of inventory of some of the services provided by coastal salt marshes. Salt marshes is a stream of goods and services that's been provided over time. One of the things it does is it takes water that's coming in from inland, and it's laden with all sorts of pollutants, all sorts of bad stuff. The salt marsh will trap that water so that the pollutants settle. And then very often, the marsh grass will suck up that water into the roots and clean it up. Yep. So you could ask, very simply, how much would you have to spend to keep your water that clean? One second. Well, there is one. There's one other study I want to mention. Adam Welchel said that scientists in New England have already figured that out. For flood control, water supply protection, pollution control, it's roughly about $31.22 per hectare per year. Then you've got to add the value of all the plants that feed the fish that end up on our dinner plates. $338 annually per acre. Then there are the bird watchers that buy lattes that support the local economy. $490 per hectare. And then there's habitat provisioning. The list goes on and on and on and on. You do get kind of. You get kind of obsessed with it. You start becoming an accountant and writing down numbers just furiously. And it gets you to think about nature in a different way than you had before. There's this galling element, though, or this aspect. Like when I first came across. At this point, our producer Tim Howard jumped into the interview, and you'll also hear our producer Soren Wheeler in just a second. I do feel like in an example like the salt marsh, which cleans water, that's all reliant on people being there that need the water. So if you didn't have people there, does that salt marsh cease to have any value? But Tim, haven't you ever had a conversation with somebody who just doesn't get. Like if you make the aesthetic argument, which is that nature should be preserved for its own sake, there's a whole category of humanity that just doesn't respond to that argument. This becomes a way to talk across the aisle. But it does still feel like it demotes something of infinite value to something of a piddly value. It can't really be. It can't really be infinite value. I mean, what does that mean? Like a mother's love. You don't think your mother's love is priceless? I mean, you know. Okay. I totally accept that there is this sort of priceless aspect of nature. But if you are in the government in a very poor country, you have some tough choices to make. If somebody comes to you and says, okay, you've got these lovely mangroves. Now, it turns out that this sort of setting where the mangroves are is the perfect place for shrimp aquaculture. Because shrimp farms need lots of seawater, so it makes sense to put them by the sea. We're going to put in these farms. We're going to grow shrimp. You are going to get millions and millions of dollars in tax revenue. If you're thinking about the welfare of all the people in your country, many of whom are starving, that might be a really powerful argument. Now, into that kind of a discussion, you can bring in the fact that these mangroves are sitting there very quietly doing all sorts of incredibly valuable things. In fact, they've done these kind of calculations. And in some cases, the services that mangroves provide are four times more valuable than what you could get out with shrimp. So it's stupid. It's just stupid in a very basic sense to wantonly replace lots of mangroves with shrimp aquaculture. Is that a hypothetical situation? No. That's a conversation you have. No, that's what we're asked. This is Glenn Marie Lang. She's an environmental economist for the World Bank. And she says, Particularly, you know, I work for the World Bank. So our primary clients are our governments. Philippines, Vietnam. And when you're talking to a minister of finance and saying, you know what? I know jobs are jobs, but you need those marshes. They have value. They'll say, well, yeah, that's true. But that means I'm going to have to reduce the money that I put into the education budget. So you've got to really make a strong argument about the benefits. That's really. That's really where the rubber hits the road. Well, I mean, that's it. Here's the counter argument. It comes from Doug McCauley and a college at the University of California, Santa Barbara. The real danger is that we actually succeed, that we convince people that nature is valuable because it makes money. And then we're really in trouble in the many instances where it doesn't make us money. What do you do in a situation, he says, where, say, a bunch of rivers are running dry and they're, quote, depreciating in value? You know, by the same logic that you train me to think with, we should go out and liquidate these natural assets. That makes me feel. Really uncomfortable. He says it's just kind of a weird way to think about nature. We had a proposal here in the state of California to make gay marriage legal. And economists had a look at this legislation and said this is expected to generate one hundred and sixty three million dollars annually for the state of California. Well, it's good to know that I appreciate having that information in front of me. However, when I'm making a decision on this legislation, and I would say that when many legislators, voters, average citizens are considering the issues at hand, they're not thinking about whether they're going to make one hundred and sixty million dollars for the state. They're thinking about a different set of values. On the other hand, I want to say, and this is based on my experience working in developing countries, that when you don't put a value on these services, basically they don't get counted. They get implicitly assigned a value of zero, according to Glenn Marie Lang. And as we were debating this and going back and forth and back and forth, we bumped into a story. about what happens when all of these values of nature ideas are let loose into a world of fruits and trees and human uncertainty. The parable of the bees. We heard this first from writer J.B. MacKinnon, who says the story begins in Mao County in central China, rural area, fairly remote. Lush green mountains filled with apple orchards. And apple orcharding was the main business. And according to J.B., in the 1990s, the wild bees of Mao County slowly started to disappear. And there was a few different reasons given for that. It could have been the destruction of the habitat that the bees nested in, the heavy honey harvesting that wasn't leaving enough food for the bees. But the prevailing theory is actually an economic one because in the 1990s, as China was shifting to a market-based economy, apple producers were under pressure to produce more apples. So they started spraying pesticide. Probably it was a constellation of all of those things and a few others. And the end result is the bees stopped buzzing in Mao County. Which, if you are an apple farmer, that's a disaster. As bees travel from flower to flower in search of nectar, they are dusted with pollen, which is the means by which flowers engage in sexual intercourse. So if you don't have the bees making the birds and the bees on the blossoms, then you don't get fertile flowers to turn into fruit. And obviously, if you're a fruit farmer and you have no fruit to sell, you have no income. So what do you do? If you're an apple farmer and you don't have bees, then you need to find some other way to pollinate the flowers. And I guess they concluded, well, we'll have to do that ourselves, by hand. In Mandarin Chinese, we say So basically, that means a manual pollination. This is Harold Thibault. I'm a correspondent in China for the French newspaper Le Monde. A couple of years ago, he heard about the apple. farmers in Mao County. So he flies to Chengdu and he and a friend hop in a car. We drive for like five or six hours until we reach this village, Nanshin. Tiny little village. Like only a few houses. And then we took a small road between the fields. And we actually saw that there were lots of farmers in the trees, like on the apple trees. Straddling up on these often thin and spindly branches, men and women that I've seen in photos in photos in photos in photos in any case. Harold and his friend took pictures and if you look at those pictures, you'll see the farmers holding a little brush. This little pollen brush that they'd constructed using things like chopsticks and chicken feathers and cigarette filters. And they'd have a little bottle filled with pollen and then what they do, they dip the brush into the bottle and they paint a flower blossom with the pollen. They dip their brush back into the pollen and they paint the next flower blossom again and they dip the brush back in again and they paint again and they dip again and they paint again. To make sure that all of the blossoms that they could possibly fertilize would be fertilized so that they would go on to produce fruit. We're talking hundreds and hundreds of flowers per tree. It was very strange to see humans doing the job of the bees. God, what a pain in the ass that sounds like. Yeah, the image of these Chinese orchardists standing up in these spindly trees traveled around the world through environmental circles and the message that it seemed to send was that they were This is what happens if you lose biodiversity. You end up standing in the trees doing the job that the bees used to do on the wing. For free. For free. Those people are just like human bees. But then this guy enters the story. This is Yin Sun Chen. Yeah, human bees. Four years ago he traveled to Mao County to do a sort of economic analysis of just how much the loss of the bees was hurting the farmers of Mao County. But what he discovered weirdly was that was that the trees were producing more apples than ever. More production. More production. This can be confirmed. There are more production for hand-pollination apple trees than bee-pollination apple trees. Humans are more efficient. Really? You mean the people were doing it better than the bees had been doing it? Yes. A lot better. Fruit production went up 30%. That's what the farmers told Yin Sun Chen which is kind of amazing. The only word I remember amazing. Because I think hand-pollination can pollinate more thoroughly. They can pollinate every flower. And bees don't pollinate every flower? Bees are a little bit you know they're a little bit uneven when it comes to pollinating. You're so polite. They don't like it if it's cold. They don't like it if it's damp. They don't like it if it's windy. In all those cases bees often decide to stay indoors and just take the day off. But you send people out there and tell them to pollinate every damn blossom and they're going to do it. And there was the additional benefit of the people that you paid they'd go to the bar they'd buy groceries they'd spend those earnings in their local communities in a way that obviously bees never did. So here you had this whole story that was supposed to be about how important the bees are and this whole parable of biodiversity. And it turns out maybe the lesson is just the opposite that actually we don't need bees and maybe we never did. If we only measure things economically then we might conclude that some species or some ecological processes just aren't necessary in certain places or that we might even do better to take care of those processes ourselves. Right. So let me find my notes about the wages exactly. But there's one more chapter to the story. Harold Thabaud told us that when he visited Nanchen I talked with one farmer his name is Zheng Zegao he's 38 and he said in his opinion the hen pollination might be going to disappear in a few years. Apparently as China's economy has continued to grow workers have started demanding better pay. The wages are getting so high for the workers that the farmers have to employ to help them. Basically it's not efficient economically to do the hen pollination anymore. That's what a lot of farmers say. Now they're likely thinking damn we need those bees back. Right, yeah. Problem is there are no bees in those villages anymore. One farmer told Harold beekeepers in other parts of China aren't going to bring their bees to this area because they worry about the pesticides that the farmers have used. As for when wild bees might come back? Well for this we have no idea. It's very hard to make a prediction. If you ask the farmers they're like we'll budge it out. I don't know. Here's where that story leaves me. It leaves me thinking that economics is just not a good way to go. Putting a value even a precise and thoughtful value on a bee or on a pound of pesticide you do it and you think you're smart but then the value changes and the bees go from being worth a lot to being worth nothing to being worth everything all within a few years. This is what markets do. They swing back forth and we pretend that we can predict but we never can. So you can't put a value on because you're always going to be wrong. That's why economics is a dumb. Well no, no. I want to argue the other side for a second. Nowhere in this story did someone walk into the middle of the proceedings and say you know what the bees do have value here's the number. In fact, you know what Carl when we were talking to him told us you know there have been estimates that the value of the pollination that comes from wild bees is $190 billion. So that's globally right but still there was nobody in the room giving that kind of number so the bees were inherently valued at zero. But remember bees are valued at zero only until humans get valued more than bees go down and bees go up. I get it, I get it. You have to have a lot of numbers in your head. But here's what I like about this idea is that when you put a number on a bee or a bat or a marsh it's like an attempt to force a kind of long-term thinking. You can't just say don't do that. I mean that's the thing that like conservationists say don't, don't, don't. But if you say don't do that because here's the value Here's the loss. Yeah, here's the loss well then that actually gives the whole precautionary don't thing some teeth. Except for this that if you go businessy on nature and you're wrong there are irreversibilities. That's how environmental economist Glenn Marie Lange puts it. This is one of the differences between nature, ecosystems and what we produce. You smash your car hey someone can build a new one. If you lose the bees many instances you cannot bring them back. So the question we got to is is there another way to think about the value of nature? I mean a way that's not economic and therefore short-sighted and all about us but also not simply about the aesthetics and the beauty because that can be sort of limiting too. Is there another way The best I was able to do thinking about this Writer J.B. McKinnon again was when it struck me that in a way all of this diversity that's out there all this biological diversity all these wonderful and amazing and alien things that other species can do is like an extension of our own brains. There's so much imagination out there that we simply could not come up with on our own that we can think about and think of it as as a a pool of imagination and creativity from which we as humans are able to draw and that when we draw down on that on that pool of creativity and imagination we we deeply impoverish ourselves you know in a sense we are we are doing harm to our own ability to think and to and to and to dream. ♪ ♪ J.B. McKinnon's book is called The Once and Future World. He's written many, but this one is my fave. Deep thanks to Carl Zimmer, who's reporting in The New York Times on this topic, is really what got us launched into this whole thing. And what got us through this whole thing is Simon Adler, whose production assistance was invaluable. That was him. Freezing his ass off in the marsh. I talked so long, he nearly died. His toes fell off, I think. Anyway, thank you, Simon. Thank you, Simon. And thank you guys for listening. I'm Jad Abumrad. I'm Robert Brolich. We'll see you next time. Hi, I'm Gabby. I'm from the Bay Area, California, and here are the staff credits. Radiolab is hosted by Lulu Miller and Latif Nasser. Sauron Wheeler is our executive editor. Sarah 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 Gable, Maria Paz Gutierrez, Sindhu Nainasambandan, Matt Kielty, Mona Modgauker, Annie McEwen, Alex Neeson, Sara Khari, Natalia Ramirez, Rebecca Rand, Anissa Vitsa, Arian Wack, Molly Webster, and Jessica Young. With help from Gabby Santus. Our fact-checkers are Diane Kelly, Emily Krieger, Natalie Middleton, Anjali Mercado, and Sophie Sandberg. Hi, I'm Aubrey, calling from Salt Lake City, Utah. Leadership support for Radiolab's science programming is provided by the Simons Foundation and the John Templeton Foundation. Foundational support for Radiolab was provided by the Alfred P. Sloan Foundation.