Everyone does it. Why can’t I?

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And this week, Ambassador Susan Rice joins me to discuss leadership, decision making and the state of the rule of law in America. The episode is out now. Search and follow Stay Tuned with Preet wherever you get your podcasts. Okay. Are you ready? Yeah, let's do it. It's unexplainable. I'm Sally Helm. You are Noelle King here with me in the studio. I sure am. Hey. Noelle, you're the host of Today Explained, the Vox Daily News podcast. Congratulations. Wonderful show. Thank you. To me, you are probably better known as that girl who texts me Onion articles all the time, I'd say. We have known each other for a very long time. Yeah, almost a decade, actually. No, no, it is a decade. It is a decade. January 2016. Yeah. Oh, my gosh. Wow. Like this week. This week. Okay. Well, during our decade-long friendship, there is something that I have never told you about myself. There can't be. There can't be. Well, I think there is. I think there's at least one thing we've never talked about. And I brought you here today to talk about it. I guess my first question for you is, what is your feeling about medical mysteries? Medical mysteries. So as a person who is a self-diagnosed hypochondriac, I do not enjoy a medical mystery. I want everything medical to be instantly known and understood and clear and taken care of. So when you say medical mystery, I'm not going to lie, I get a little anxious. Great. You're not in luck because today we have a medical mystery. That is what we were going to discuss. Okay. And first up, I'm going to play you some audio of people discussing the symptoms that they're experiencing. You just feel nauseous, you know, after drinking, I guess, one beer or one whatever. Even a glass or two of water can do it. Really bad bloating. All the CT scans showed a lot of air in my intestines. But no one knew why and why it wasn't moving. It's almost like a dam is holding everything back to your throat. It's extremely painful and it's very debilitating. There were moments where I can't really live like this, where I'm lying in bed at night. And it almost felt like I was in this torture chamber of my own body, you know? Do you have any guesses right off the bat about what's going on? This sounds digestive to me. Maybe this sounds like something in the old, what we used to call the plumbing. You're thinking guts? Yeah, yeah. I'm thinking guts. I'm thinking this is a gut issue. But beyond that, no, I don't know. Okay. I'm going to tell you more about it. Okay. But first, I do have to reveal that I actually have this condition myself. Oh, girl. That we are discussing today. I'm so sorry. Thank you. Yeah, like the stomach bloating, the weird throat sensations. And there is another symptom that is auditory. People like me who have this condition, we make certain sounds that other people don't make. And I did put together a little medley for you. Some of these are me. Some of these are other people with the same condition. Okay. Here's some audio. Whoa. Whoa. What? Oh, no. Sean. Sean. Sean. What is this? What is that? So what did that sound like to you? How would you describe those sounds? Okay. Fortunately, I laughed through it. So I can't tell you exactly what I was hearing there. But actually, I will say, nor do I want to. I don't want to tell you what I was hearing. I mean, so a lot of people compare this to a frog sound. There's like a ribbit that can happen. I also have heard dinosaur. I've heard monster. I've heard I sound, quote, demonic slash possessed. Frog. Let's stick with frog. Frog is gentle. Frog is good. Little ribbit. Okay, I do want to reveal, you said you don't like medical mysteries. I do want to assure you that actually, Noelle, the cause of these symptoms is not, in fact, a mystery. Oh, okay. The cause of the symptoms is that I cannot burp. You can't burp? I've never been able to burp. Wow. Did you know that about me? No. No. Yeah. Can you burp? I can. I'm not going to do it on tape because I'm a lady. But yeah, I can. Yeah, I've never been able to burp. And it's this really annoying problem. It sounds funny when I tell people because it has the word burp in it. But actually, it's like there were weeks of my life where I would have to just lie down all afternoon because it was the only way to get comfortable. Yeah. I ended up talking to a doctor who treats this, and he was like, there is definitely a range. But some of the patients that I see with this condition have what I would call severe daily misery from not being able to burp. Yeah. Yeah. And I mean, I would say that I have not had the worst case ever. Okay. But, you know, it has been bad sometimes. Yeah. And yet it was also not something that I really thought to mention to people that often, you know? Like, it's weirdly beneath the world's notice. Like, no one ever talks about burping. Really? You know? Like, when would it come up? You're right. There's not, like, a lot of good options. Like, you never told me you are a burper. so all right the medical mystery is half solved but noelle do you think that i called you here to solve a medical mystery in one minute no no surely not and there are a couple of mysterious things about this condition so one of them is just like why can't i burp because i can swallow yeah and it's the same muscle you know so it's like it can go down to let in food why can't it go up to let out a burp. Another mystery is why the medical system has for some reason been almost completely blind to this condition. It was only named in the medical literature in 2019, which it's like weird to me. It's so weird. So many things were identified by 2019. So many things. And this doesn't sound, I mean, you could tell me, it doesn't sound like it's that uncommon. You have all these people on tape saying they're going through the same thing. It's really hard to say how common it is. I think it's like somewhat rare, but not like super, super rare. And also it's just really easy to recognize. Like it's like I can't burp. Right. Right. That is the problem. Simple diagnosis. It's very easy to describe. Yeah. And yet, yeah, it was not named for many, many years. And that can be like a real problem. Like I talked to this one woman who you actually heard at the beginning. Her name is Dori Gray. And in her case, the doctors were like completely stumped for years. I ended up having every test you can imagine having to do with your intestines. Eventually, the doctors were all like, we don't know. We did every test. We can't figure out why this is all happening to you. Go see the surgeon and see what he thinks. And Noelle, this woman, Dory, eventually had not one, but two separate surgeons suggest to her that maybe she should just remove her colon to solve her problem. Oh my God, no. I know. And thank God she did not do it because now she is pretty sure that the root cause was not like having a colon, but it was actually the fact that she could not burp. No one ever said, you know, do you burp? I never thought about not burping. It just wasn't on my radar as a thing. Dory did eventually do something to try to solve this problem at its root. And that brings us to mystery number three, which is a really good one because for some people, there is now a mysterious, but possibly permanent cure. Oh. And I have just recently tried it in an attempt to finally learn to burp. Okay. So I'm gonna tell you that story today. Are you ready? Yeah, let's hear it. Our main character today is a hero to all No Burpers Everywhere, and his name is Dr. Robert Bastion. Okay. He is a laryngologist in Illinois, and I'm going to play you a little tape to help you get to know him better. My mind is one that goes to sort of solutions, and so I've done some of those online inventories, you know, StrengthsFinder and Colby. Noelle, you know that I love a personality test. I love a man who looks for solutions. I learned that about myself that I a strategic thinker I an optionizer and I also a physician who leans to the observational side You know, the scientific method is to test a hypothesis based in observation or measurement. And so what I would say about the medical profession is that it leans heavily towards measurement. So sometimes I say when I teach, I say, you know, measurement gets respect. Observation does not get respect. But Dr. Bastian is a real listen to the patient kind of doctor. He doesn't like to get bogged down in unnecessary details. He doesn't want to run a zillion tests if that's not necessary. I mean, not that he's not interested in facts. He does also run a website called Laryngopedia, which is a voice and swallowing disorder encyclopedia. And one day, Noel, he gets an email from a guy in Texas who says, can you help me, Dr. Bastian, because I cannot burp. It has been a lifelong problem. But he is moved to send the email at that moment because he had also picked up a new hobby that was making not burping especially difficult. Do you want to guess what it is? Drinking soda? Good guess. Totally wrong. The new hobby was skydiving. So, he said when he goes up in the airplane, he just becomes incredibly uncomfortable. Other people are burping and he couldn't burp. Wait, so wait, this is now a tangent, but when you go up in an airplane to skydive, that causes you to burp for some reason? Well, have you ever noticed that the potato chip bags get really puffy when you go up in the air? So, because he had a lot of air in his stomach and he needed to burp it out, he couldn't do that. he said he became incredibly uncomfortable because his stomach became like that potato chip bag. Over the years, he's seen all these doctors. No one can figure it out. But now he wants to be a skydiver. So he really goes deep and he finds his way to laryngopedia and to Dr. Bastian, who it turns out is like the perfect person to talk to here because he works a lot with this particular swallowing disorder that has to do with the muscle that is clearly involved here, which is the upper esophageal sphincter muscle, also called the cricopharyngeus muscle. It's like a circular muscle that opens and closes. And, you know, for normal people, you're probably familiar, air will come up your throat. It will present itself to this muscle and then the muscle relaxes and the air comes out. And for this person and for me, that is not happening for some reason. So our problem is that the muscle is not relaxing properly and maybe even is clamping up. So Dr. Bastian, he's familiar with this muscle. And he also, as we've discussed, has this very particular personality and this like particular medical style where he leans towards observation. And so just getting this email where this guy is describing his own observations very clearly. Here is my problem. The problem is I cannot burp. Here's what it feels like. Here's what happens to me. And Dr. Bastion, like, that is giving him a lot of information. He's like, okay, it sounds like this guy knows what the problem is. Tick, tick, tick through the possible solutions in his mind. And, like, he actually pretty immediately comes up with an idea. I said to him, well, you need to have somebody put Botox into your upper esophageal sphincter to help you burp. This actually makes complete sense to me, because when you think about it, Botox, they use Botox to freeze all kinds of things. right? Exactly. Yes. Yeah. Yeah. Yeah. Okay. Smart man. You know, you use it between your eyebrows or whatever so that you don't get wrinkles there because the muscle can't move. Right. And so exactly. He's like, this will paralyze the muscle. And then this man will have no choice but to burp because the muscle can't clamp up in this in this way. And in fact, he has actually injected Botox into a nearby part of the body, the larynx. I do 100 injections a month for a rare neurological and condition of the voice. Wow, does that work for that disorder? It works beautifully, beautifully for that disorder, just beautifully. And so in all those people, they come two to three to four times a year and repeat the treatment. He's done it before. It's not like it's dangerous. Right, yeah. So Dr. Bastion is like, okay, I'm going to inject this guy with Botox. That'll get him burping. And then when it wears off, because it wears off in like three months, I'll just do it again. And he can just burp for the rest of his life. So he does this. He sends him on his way. And then, Noel, other people start showing up in his office because, unbeknownst to him, this guy has been posting about his experience on the Internet. And there is this thriving no-burper community on Reddit and Facebook where people are being like, I can't burp. The doctors are telling me to remove my colon. Like, what do you guys think we can do? And these patients have a very particular symptom cluster that Dr. Bastion starts to recognize. So obviously, can't burp, chief among them, bloating, the gurgling. A lot of people experience a higher level of flatulence for obvious reasons. Oh, no. There are a few random things like painful hiccups. Are your hiccups painful? No, they're annoying, but not painful. Yeah, mine have always been painful. I did not know until college that that was like not normal. Another interesting thing is that more than the general population, We know burpers tend to have emetophobia, which is a fear of throwing up. What do you make of that? My sister and my niece have emetophobia. It is not a game. I mean, you should check if they can burp. You're giving me all kinds of ideas right now. Yeah. Yeah. Well, so, okay. So I saw one study that raised the idea that people who can't burp might be subconsciously tensing this muscle. So I was like, maybe you're tensing that muscle because you're scared to throw up. And yeah, you don't throw up, but also you can no longer burp. But Dr. Bastion told me another theory, which is that throwing up can actually be painful if you have this condition. So maybe it goes the other way where early on you had a painful experience of throwing up and then that actually causes your emetophobia, not the other way around. Isn't that interesting? That is incredible. It is. And also babies throw up. So it does strike me that you could very early on be a baby. Babies throw up a lot. You're having this reaction. You're feeling as a baby pain. And so you're, you know, you get older. You're not putting two and two together. Why am I afraid of throwing up? Oh, because I don't remember being an infant. Yeah. Wow. I mean, that's basically Dr. Bastian's theory, although he's like, I don't know. Like, I don't know if that is true. I will say some of us snow burpers could not burp as babies. Like there's stories of you just like can't burp at all. I know. I had colic as a baby. So I was like crying all the time. And Dr. Bastion was like, you were probably an inadequate burper. Like, you probably could burp, but not quite right. Yep. Okay, so anyway, so he's getting this sort of symptom cluster. He's trying to figure it out as best he can. But eventually he's like, I should go read the literature on this. Like, I should just go see what people have written. And to my great surprise, there was essentially nothing. I was astonished. I thought I didn't think there was anything left to discover. Or, you know, once you know about it, it's so obvious. But that's the problem with a lot of things in life. Things aren't obvious sometimes until they're obvious. Dr. Bastion does publish a paper on this in 2019. He names the syndrome, and I call it no burp syndrome. That's what the Reddit is called. But its official name is retrograde cricopharyngeus dysfunction, RCPD. I have mixed feelings about Reddit. But in this case, you have a bunch of people who are all suffering from the same thing. And it's not like there wasn't anything. And he actually had some interesting specific theories about why medicine missed this. And one of them is like interestingly logistical. He was basically just like, I mean, your first instinct was this is a gut related thing. And a lot of people end up with GI doctors if they have this condition. But this muscle is at like the top of anything a GI doctor would think about. But it's at the bottom of anything an ear, nose and throat doctor would think about. So he's like, it's kind of an orphan area, he called it. Like, it just like gets a little lost. No one's really thinking about it. And then the other thing I thought was so interesting, it goes back to his whole thought about like observation being a little bit maligned or like not taken seriously. Because like this is what he would call a syndromic diagnosis. So there's no like one test that you can just do when someone walks into your office. It's just like you talk to the patient. do they have this cluster of symptoms, which, again, is like pretty obvious. And at this point, the year 2026, his practice has treated about 2,400 people who can't cope. Wow. Wow. Just as a wild guess, taking it out of the air, I would imagine that there must have been at least 15,000 major tests done on these 2,400 people before they came to us. Wow. So they've had barium swallows. They've had bolus scintigraphy. They've had stool cultures. They've had upper GI scopes. They've had colonoscopies. They've had everything imaginable. And out of those 2,400 people, the diagnostic rate was exactly zero. All that testing and nary one single diagnosis. Wow. And on the other hand, every single person he has seen who has diagnosed themselves as a no-burper on the internet has been correct out of this like 2,400 people, except he did say there was literally one guy who just seemed to have like not really paid attention to the details. He was like, no, you don't have it. But like basically 100%. So when I teach on this subject, I say to doctors if patients can diagnose themselves accurately 100 of the time then why can we doctors do the same There have now been a couple of studies that do testing to confirm that this condition is real They put a like freaking catheter through your nose and do like a pressure sense down your throat to see if you're burping. And I emailed with one of the authors and he was like, yeah, I really, I didn't think this was a thing, but then our study did confirm it. Incredible. And so two studies have said, wow, these people can't burp, to which the patient would respond, yes, I told you that already. Right, that's why I'm here. But it is nice. We've got now proof of the disorder. But my comment is, okay, thank you very much for proving this for us. But now don't hassle people. You don't make new individual patients submit to that test, that very obnoxious test. That feels right to me. And like this thing about observation and measurement, like it does make sense to me. Like what are your just off the cuff theories of why doctors are generally ordering tests? Okay. So I have two theories. One of them is that doctors know that there are people like me who diagnose themselves on the internet, come in and say, I have this very rare disease. And they're like, no, Noelle, as a matter of fact, you don't. you're paranoid, you're a hypochondriac. So that's one. The second thing is I imagine there is some financial incentive here when it comes to testing people. People pay for tests, et cetera, et cetera. And I don't want to be cynical or suggest that like, you know, the medical profession is out to get us. But whenever there's money involved, I get curious about like who's making it and who's paying it. Sure. Or even just like the prospect of getting sued is something I was thinking about. But like I'm sure if you get sued one time, then you're like, oh, my God, I'm never going to not order. You know, like you just. Right. I will say Dr. Bastion did seem pretty sympathetic to the Internet diagnosis thing in general. I think it's true that sometimes people get themselves into a lather. But he's also like, you know, it's kind of great. You you get a little further on your own diagnosis. It's usually pretty clear to me whether you're right or wrong. Like it takes me one second to talk to you about that. And he did also say, though, he was like, I do think medicine like over indexes on fact finders, just people who really want to pin down all the details. They're like trees people, not forest people. Yeah. And med schools really like that. You know, it's like this like fire hose of facts. And he's like, maybe it just kind of draws people who are into that. But he's putting in the plug for observation, you know, like it's part of the scientific method, too. And people should respect it. People know themselves. And Noel, do you remember our Texan skydiver who got the Botox? Yes. And Dr. Basham was expecting him to come back in a couple of months for another round. But Noel, he mysteriously kept burping. It, like it worked and then just kept working? In fact, it did. And as far as I know, he is still burping. Huh. And all these other patients who Dr. Basham was treating, a huge number of them also kept burping beyond the three to four months. So I thought, all right, well, now I have to figure out why on earth would a single Botox injection fix these people permanently? This does not make sense. It does not make sense. It doesn't make sense, yeah. And yet, obviously, if you're me, you want to try it, right? Oh, yeah, immediately. Today. So in November, I went to get the Botox to see if I am among the pretty large group of people for whom it might be a permanent cure. Wow. And that is after the break. It's time to level the f*** up. I'm Robin Arson and I light fires. I'm an executive, founder, bestselling author, ultra marathoner, mother, proud Latina, and I'm not done yet. Announcing Project Swagger, my new weekly podcast, Your Transformation Toolkit. I'm going to cut through the noise and give you actionable takeaways each week in under 30 minutes. Elevate your hustle with routines, strategies, and mindset shifts that I have pressure tested. I have burnt down this Beyonce candle, like, all the way to the bottom. We have been trying to manifest. Carves are not the enemy. I probably have a piece of bread or a bagel with me at all times, and I am not exaggerating. Tune in on February 24th for episode one, Building the Skill of Self-Talk. This is the foundation. Follow Project Swagger wherever you get your podcasts. Let's go. When you look beyond the headlines at the trend lines, what is really going to matter? Even if you're not worried about AI per se, you certainly ought to be concerned, do we have the cultural, you know, strength and resilience to get it right now? Imagine we had to write a new constitution today, put aside AI. Like, how good a job do you think we would do? I'm John Feiner. And I'm Jake Sullivan. And we're the hosts of The Long Game, a weekly national security podcast. This week, we're joined by economist and author Tyler Cowen. We discuss China, the AI race, and aliens. The episode's out now. Search for and follow The Long Game wherever you get your podcasts. Wuthering Heights is here and the people are furious. Where did Emerald Fennell come from? This week on Good Noticings, we did a deep dive into director Emerald Fennell's life and filmography. And before you say anything, yes, deep enough to know that it's Emerald Fennell. We also were wondering what's going on with the ice at the Olympics. Why is it so slushy? And why are those Mormons drinking so many slushies? They're not drinking slushies. They're drinking dirty soda. This week, we are also talking about the Mormon takeover in Hollywood. Plus, Margaret Qualley's first ever cover interview. How did it go? Well, she always has the next one. Finally, can you buy a spell on the internet? Or does witchcraft have to be done in person? We are covering it all this week on Good Noticings. I'm Claire Parker. And I'm Ashley Hamilton. And Good Noticings is out every Wednesday, wherever you get your podcasts, plus YouTube. I'm so excited. I'm so excited. You're getting the talks. I'm getting the talks. You did say you would go for this immediately. Yes. I dragged my feet on this for years. What? But eventually I was like, look, there is no single other problem in my life that I can solve with one injection. And like, I'm going to do it. So in November of last year, I went for it. It's about 4.30 a.m. My alarm just went off. So I did do this in the operating room under general anesthesia. I'm not supposed to have any food or water. This is a reminder to myself. They also told me that I had to take two showers, Noelle, I guess for germs in the operating room. It was intense. You can just do it in the doctor's office. The needle just goes in through your neck, but that is not as precise. There can sometimes be voice-related side effects, which wouldn't be great for me. So anyway, I ended up doing it in the operating room, which means, you know, got to the hospital, went up to the surgical floor. Third floor. Going up. I got my gown. All right. They took my vitals. Heading in soon. I didn't have my phone with me for the surgery, obviously, but the vibe was like really jolly. The anesthesiologist was this funny guy. I go to sleep. I wake up. It takes five minutes. They did intubate me to protect my airway. Yeah. And then they just inject Botox into this muscle at the top of my esophagus. Okay. I'm out. It went well. I'm in the recovery room. Little sore throat, but everything seems good. I'm not even that groggy. Hopefully burps soon. What questions do you have at this moment? What are you wondering? Well, first, I heard you say it was 4.30 in the morning. I feel bad because I know you don't like to get up early. Second, I will say you are one of the least decisive people I've ever met. So actually, it totally tracks to me that you learn about this. And then years later, you're like, I'll get this done. But now, but now you did it. You did all the things you need to do. And now I just want you to test it out. I'm like, but do you know one question I have genuinely? Do you know how it works? Do you know that you have to like kind of like gulp air in and then like, do you know how to do that? That is such a great question. So, okay, we're going to get to that. Basically, I mean, my question is I was like, am I going to be burping uncontrollably immediately? Because I've never done it, you know, and I'm like, it's embarrassing. I'm going to be like, can I go to work? Like, what's going to happen? And I did read a Johns Hopkins, like, explainer about it. And it was like, in the first couple of weeks, you will be burping exuberantly. I was like, oh, no. But it is not immediate. It does take a few days, usually, to kick in. So, like, in the 48 hours after the surgery, I'm just watching every movement in my throat. And so I left my phone running while I was working. Yeah. Here's some sound. like what does that sound like to you i mean it's the croaking from the beginning we're gonna say frog frog is gentle right i was still it was still frog sound but like i could feel that it was like getting ready so okay so it's two days after the surgery that night i had had dinner with my friend John I was walking down the street I was in the middle of talking about something and suddenly John what just happened I heard a belch You did Like that Yeah a legit belch That was one? Yes. Oh my God. Really? Yes, it came from deep inside you. Oh my God. But it was like while I was talking. Yeah. Like that kind of. Oh my God, that was kind of a burp. No, now I think you're looking too hard for it. Noelle, what do you think? John is so game. He's so game. He's like, I'm here for you, girl. I'm proud. What I feel right now is proud. I feel like you did it. Thank you so much. I mean, it's so funny to listen back because I obviously I cannot hear whatever things I was experiencing as burps in that moment. But like it felt like I kept burping while talking. And that was really a feature of the next couple of days because to me, any burp seemed so loud and surprising in my head. I had never experienced this. So like the next night during dinner with friends, I kept burping. But what it looked like to them was that I was just stopping in the middle of talking and like making this incredibly surprised face. Okay, so tell me about... That was a burp to me. Was it to you guys? It was really, it wasn't perceptible on any level. It was just a look of shock on your face. There was no sound or movement. Okay. All right. There was a little sound, I promise. but that's great to know. You guys have been having this experience the whole time. Yeah, it's crazy. I just did it. I just burped and nobody was aware of it. Because I think what happens is like you feel it coming and you like either you like finish saying what you're going to say or you go, excuse me, and then you continue. Like I feel like people do this all the time like in interviews and podcasts and stuff. People will like pause for a second because they're burping. Whoa. That was weird. That was real. But we have no inhibitions. I have no control. Well, if you didn't catch it, I said I have no control and I burped on the word control. You have a very supportive community. I really do. Thank you. One thing, it really was so interesting to me that everyone has just been secretly burping around me all this time. Like, have you burped while we've been talking? I have not while we've been talking. But like when your friend said, like, if you're doing a podcast interview or something, like you just sort of like say, excuse me or hold on a second. Yes, of course, I talk for a living. I do that all the time. It's so funny because I actually I had the experience a bunch of times where I would be telling people about what I was going through burp wise and they would be like, oh, I never burp. And then later in that conversation, they would be like, oh, I just burped. Like, I think you don't pay attention to it. You don't realize it until someone brings it to your attention and tells you, like, I can't actually do this. And then you're like, oh, wait, no, I do this all the time. Exactly. Like all the time. Mm-hmm. So in the weeks after the surgery, I was burping a lot. I was not in control. Like, for example, three weeks after the surgery, I was out to dinner with my sister and my college friend, Margaret. And I burped. Interesting. Okay, but then I started laughing, and then the laugh became burps. That's some laughing. What do you think? I'm so proud of you, mama. Thank you. I'm so proud of you. Okay, so I did start to get a little bit better at it, like get a little bit more control. I discovered that a body posture that worked really well is, you know when you're reversing a car and you put your arm out over the passenger seat and you like turn your head over your shoulder? So I did that and it was just like burp city right away. Backing up in the car. Oh, my God. Why is it like this? I literally didn't even know I had to burp. Okay, so also often during this time, I would, like, get into this really weird position. Like, I would do the basically, like, backing out in the car thing, but I would put my arm on the wall, and then I would, like, turn my head around and, like, dip my chin and crank my head. My family was very supportive, but they were also confused. Like, I burped while I was hanging out with my sister and my dad. Are you proud of me? I just did a little sputter burp and you heard, are you proud? Oh my God. Yeah. But why did you have to do it in that weird contortion? Wow. That was such a weird one. Did it come out? Yeah. Well, look at this. What I am sort of shocked by, in all honesty, is that you went, we're not going to age ourselves, but you went 30 some odd years without being able to do this. One surgery and like fixed? Yeah. I mean, so number one, it might not work permanently for me. Like it doesn't work for everyone. And also it's only been around for about 10 years. So it remains to be seen whether it can last forever. But as of now, there are a lot of people who did the Botox and can still burp. So I did talk about this with Dr. Bastion, right? Because I was like, what is going on here, right? Like, why is this happening? I did actually burp on the call with him. Good. That was a good one. Thank you, Dr. Bastion. It just turned a little bit. So that's good. So I'm getting there. And you opened your jaw. But that lowers your larynx, I think. So think about lowering your larynx. Work on that one. Okay, so this was very interesting to me. He was really adamant that I needed to be like consciously practicing. And I'm supposed to like find the little posture that makes me burp. So every person who burps does something just prior to the burp. So there's a gesture, there's a fidget, there's a, I don't know what to call it. But I don't like calling it the Belch reflex because it does have some voluntary input. So that's the idea. It's like, I need to figure out what can I do not to force it, but to invite it. Do you have one of these, Noah? Like, does this resonate for you? I don't think so. But I will tell you that it's not something that I've ever thought about. I mean, he's just interesting. He said, he was like, many burpers are not aware of it. Like, they feel like they're doing something without any involvement of theirs. But actually they are doing something like there's like a ab thing or like move your shoulders. And basically his theory is just like everyone actually needs to do this to like invite the burp. And for whatever reason, some subset of human beings, which includes me, just early on in their lives, like didn't learn how to do this or they learned it wrong. And that is basically also his theory for why Botox might be able to permanently cure the problem. Why are people still burping? My answer to that has to be, well, they figured it out. So his theory is that, you know, Botox paralyzes this muscle, and that gives you the opportunity to learn the skill of burping, and then that learning sticks. And Noel, I am now about 11 weeks out from the surgery. So I am coming to the end of this window where Botox is helping me burp. the training wheels are about to come off and I really gotta hope that all the practicing that I have been doing is gonna carry me through I have been drinking a seltzer while we've been talking should I give it a try? Yes you absolutely should okay it's so good it is so good I really hope it lasts here's hoping I'll let you know Really big thanks today to Noelle King, host of the podcast Today Explained. And if you are not listening to that podcast, what are you even doing? You should go subscribe to it right now. Another very, very special thanks today to everyone from r slash no burp who sent me their stories and their gurgles and who agreed to be interviewed about RCPD. you heard the voices of Anders Birkness, Dory Gray, Matthew Dahl, and Elina Lin. I so, so appreciated hearing from absolutely everyone who wrote to me. Thank you so, so much. This episode was produced by me, Sally Helm. It was edited by Jorge Just with help from Joanna Solitarov. Joanna also runs the show. This episode was sound designed by Christian Ayala and fact-checked by Melissa Hirsch. Noam Hassenfeld to the music. Amy Padula, Meredith Hodnott, and Julia Longoria all know how to burp. And Bird Pinkerton was like, what? White room? Station? Sun doesn't shine, but the shadows run from themselves? She had no idea where to find Eric Flapton. But then she remembered. Flapton was a bird. And she had a beak beeper. thanks as always to brian resnick for co-creating the show along with bird and noam and if you have any thoughts about this episode we are at unexplainable at vox.com i will say if you think you might be a no burper you are probably right and i would love to hear from you if you want to support the show and help us keep making it please join our membership program at vox.com slash members. You will get ad-free podcasts and other perks and unlimited access to Vox journalism. You can also support us by leaving a nice rating or a review or by telling people you know to check out Unexplainable. Unexplainable is part of the Vox Media Podcast Network, and we will be back in your feed very soon. Thank you.