Ologies with Alie Ward

Human Technomorphology (SWAPPING OUT BODY PARTS) with Mary Roach

58 min
Sep 17, 20257 months ago
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Summary

Mary Roach, bestselling science author, discusses her new book 'Replaceable You: Adventures in Human Anatomy,' which explores how humans modify and replace body parts through surgery, transplantation, and emerging biotechnology. The episode covers xenotransplantation, prosthetics, tissue donation, gender-affirming surgery, and 3D bioprinting, with Roach sharing her reporting methodology and emotional moments from interviewing experts worldwide.

Insights
  • Science writing success depends on finding compelling 'nuggets' (specific scenes, people, or moments) and building books around them rather than starting with abstract topics
  • Functional prosthetics now prioritize performance over aesthetic 'wholeness,' with specialized attachments for sports and activities, challenging societal bias toward able-bodied appearance
  • Xenotransplantation using genetically modified pigs could extend organ viability from months to years, potentially creating 'personal pig' organ farms via chimerism and pluripotent stem cells
  • 3D bioprinting faces fundamental engineering challenges: printed organs need blood supply (capillaries) and feeding mechanisms, requiring balance between what must be printed vs. what the body can regenerate
  • Regulatory and liability concerns increasingly restrict researcher access to journalists, forcing alternative reporting locations and limiting transparency in emerging medical fields
Trends
Shift from cosmetic prosthetics mimicking biological limbs to openly bionic, performance-optimized designs across sports and occupational applicationsGenetically modified xenotransplantation moving from theoretical to clinical trials, with multi-gene edited pigs enabling months-long organ survival in human recipientsPluripotent stem cell technology advancing toward 'off-the-shelf' stealth cells to reduce bespoke, expensive personalized medicine to scalable, insurance-covered treatments3D bioprinting transitioning from proof-of-concept to solving real engineering problems (support gels, capillary networks) for tissue and organ fabricationInstitutional resistance to media access in biotech/medical research due to liability, social media risk, and regulatory uncertainty, limiting public understanding of emerging therapiesElective amputation gaining recognition as valid medical choice when prosthetics offer superior function to compromised biological limbs, challenging 'wholeness bias'Gender-affirming surgical innovation using creative anatomical repurposing (colon vaginoplasty, finger penile reconstruction) with high patient satisfaction outcomesTissue donation infrastructure (bone, skin, tendon, muscle) enabling 75+ people to benefit per donor, yet 90% of potential donors rejected due to disease/lifestyle screeningVertical farming and industrial-scale pig production (26-story facilities in China) enabling future organ supply chains for xenotransplantationScience communication evolving toward immersive, first-person reporting where journalists participate in procedures to convey authentic sensory and emotional dimensions
Topics
Xenotransplantation and genetically modified pigs for organ transplantsProsthetics design and functional specialization for sports and occupations3D bioprinting technology and tissue engineering challengesPluripotent stem cells and regenerative medicineOrgan and tissue donation infrastructure and screeningGender-affirming surgical procedures and techniquesElective amputation and patient autonomy in body modificationScience communication and narrative nonfiction methodologyInstitutional liability and researcher access restrictionsChimerism and human-animal hybrid organ productionCadaver tissue banking and CORE (Center for Organ Recovery)Surgical innovation in reconstructive and gender-affirming proceduresRegulatory frameworks for experimental medical proceduresAmputee Coalition and disability community perspectivesOstomy and continent diversion surgery support
Companies
United Therapeutics
Xenotransplantation company creating genetically modified pigs for organ transplants; Roach was unable to access for ...
eGenesis
Biotech company developing gene-edited pigs for xenotransplantation; Roach was unable to access for reporting.
Carnegie Mellon University
Houses a 3D bioprinting lab where Roach spent a day observing collagen and extracellular material printing research.
Cedar Sinai
Medical center with transgender surgery and health center; Roach interviewed urologist director about gender-affirmin...
CORE (Center for Organ Recovery and Education)
Pittsburgh-based organ and tissue recovery organization; Roach visited to understand donation screening, acceptance r...
Amputee Coalition
Non-profit serving 5.6 million Americans with limb loss and limb difference; featured as episode donation recipient.
United Ostomy Associations of America
Advocacy organization for ostomy and continent diversion surgery patients; featured as episode donation recipient.
NASA
Space agency mentioned for astronaut bone loss research and Devon Island analog facility for Mars/moon mission simula...
Extra Corporeal Life Support Laboratory
Research facility studying ECMO devices that support body functions outside the body; Roach gained access after conta...
People
Mary Roach
Seven-time New York Times bestselling author discussing her new book 'Replaceable You' and science communication meth...
Alie Ward
Podcast host interviewing Mary Roach; expressed deep admiration and emotional connection to Roach's work and career.
Leah Bellis
Stem cell lab worker who told Roach about finger-to-penis reconstruction surgery, sparking the 'Replaceable You' book...
Judy Berna
Reader who suggested football referees book topic; revealed she is elective amputee with spina bifida, inspiring ampu...
Xiaoping Dong
Chinese xenotransplantation researcher who predicted future of 26-story pig farms producing organs at scale.
Adam Feinberg
Bioprinting researcher who patented support gel method for 3D printing organs without structural collapse.
Bob Bartlett
ECMO lab director who granted Roach access after public affairs office initially ghosted her due to animal rights con...
Clark
Arctic researcher developing escape suits for spacecraft; wife Laurel Clark died in Columbia shuttle disaster, motiva...
Mark Randolph
Long-term iron lung user whose marriage to Mona and daily caregiving routine became emotional centerpiece of Roach's ...
Quotes
"I wish I had a really cool inspiration story because I'm usually not inspired. It's rather like a period of random flailing."
Mary RoachEarly in interview
"What normally happens is I stumble onto something that I think is kind of cool and interesting... and then I kind of build, I think, well, what would be the book that goes around this nugget?"
Mary RoachOn book development process
"I have a zero tolerance policy for PowerPoints. I need stuff going on. What do you got? What's coming up? What can I see?"
Mary RoachOn reporting methodology
"It's just very sci-fi, very much, you know, the matrix kind of the pod being used to create whatever the living people need... your own pig and goop. You've got a pig somewhere waiting for you."
Mary RoachOn personal pig xenotransplantation concept
"Sometimes what you think the chapter is about needs to scooch over. And you need to give this person room to talk about what it was like to be with her."
Mary RoachOn emotional moments in reporting
Full Transcript
Oh, hey, it's last year's calendar. You don't know if you should throw away. Allie Ward, and this is a very special episode of oligies that I know so many of you right now are losing your damn minds. Friends, I'm right there with you. Wow, over the last 20 years, this guest has written so many New York Times bestsellers. It's a labor to list them all, but I will because they are glorious books. So you may know these titles. Stiff, the curious lives of human cadavers. Spook, science tackles the afterlife. Bonk, the curious coupling of science and sex. Packing for Mars, the curious science of life in the void. Gulp, adventures on the elementary canal. Grunt, the curious science of humans at war. And fuzz, when nature breaks the law. This guest is the Meryl Streep of science writing. I looked it up. Meryl Streep has three Oscars. This person, seven New York Times bestsellers. Absolute goat with just an eight brain and a notepad. This person has changed the way the public interfaces with science. Now, because of that in the first half, I just barrage them with questions about science communication and how they write books and their approach to storytelling and conveying science to the public, what it's like behind the scenes. And then in the second half, we really dive into your questions on human technomorphology, which is the topic in their latest book, Replaceable You, Adventures in Human Anatomy, which comes out today, September 16th. I had to wait to put this up until today. Get the book. Love it. I read it in a day and a half. It's like a bingeable book, this one. So this interview, Side Note, had to be rescheduled a few times just because of some tech glitches. And right after we did record, I closed my laptop and I started crying, but you will find out why in a bit. But first, thank you to patrons of the show who support us for as little as a dollar a month and submit questions before we record. Thank you to everyone wearing things from oligiesmerch.com. Thank you to all the caring souls who leave reviews of the show because you know it helps and you know I read them, including listener Recommended in Dreams, who wrote a review saying, seriously, twice now I have recommended this podcast to people in a dream. Recommended in Dreams, I thank you in dreams. Also, if you want some G-rated, family-friendly versions of oligies, you can subscribe to Smoligies, which are classroom safe edits. They're in their own separate feed, S-M-O-L-O-G-I-E-S. You can find them at the link in the show notes or wherever you get your podcasts. G-rated, good for everyone. Also, thank you to sponsors of the show who make it possible for us to donate to causes of the oligest choosing each week. Okay, let's get into how and why we modify the human body, past, present, and future as we talk to this author and journalist who has gone to actual ends of the earth to interview the finest experts with the best stories. So prep your flesh for figuring out how to write a book, getting to fourth base in a lab, organs from critters, how to find the best nuggets of a conversation, bugs on drugs, bendable genitals, elective amputation, gene-tweaked pigs, vacuum chambers, beating hearts, leftover tendons, and so much more with replaceable you, author, science communicator, lauded journalist, my personal career hero. I like them so much. It's embarrassing. The icon and writer on human technomorphology, Mary Roach. My name is Mary Roach and my pronouns are she and her. And Mary Roach, an icon, a legend. I've read all of your books, including I got an advance copy of a book coming out. Your book will come out the day this is released. And when it comes to your books, does the name come first? Does the subject come first? Do you have leftover pieces from another book that you realize all fit into a new book? How did you decide on the topic? You know, I wish I had a really cool inspiration story because I'm usually not inspired. I don't know. It's not like there's a moment of inspiration. It's rather like a period of random flailing. You know, where I was just like, what about this? I don't know. I think this might work. Nope, that's not going to work. And then I move on to something else. But what normally happens is I stumble onto something that I think is kind of cool and interesting. It would be a good scene and a place to go. And then I kind of build, I think, well, what would be the book that goes around this nugget? You know, or sometimes there's two nuggets, like for Packing for Mars. I had years and years ago for Vogue magazine of all places because look at me. I'm a absurd that I wrote for Vogue magazine. I was a contributing editor at Vogue magazine. It was hilarious. I would hide when I went to meet my editor. I was like, don't let me run into Anna Wintour. She'll ban me. And you have no style or sense of fashion? So anyway, I was doing this story about osteoporosis. You know, I was like, this isn't all that interesting. What should I do to kind of punch it up? And I thought, okay, I'll talk to an astronaut because, you know, you lose bone in space and it's something that astronauts have to deal with. And if they discovered how to deal with it in space, we old ladies like me who are losing their bone could have a cure. And so, okay, so I'm on the phone with a guy. He's like, it's an interesting conversation, but not really that interesting. And we get to talking about other things and inevitably with space, it comes around to, you know, what's the toilet scenario? He tells me that there's this, at NASA, kind of like a training party. You know, you have a toilet with a camera down in the bowl facing up with a closed circuit TV next to the toilet showing you what that video camera is seeing. So it's like this view of something you know very, very intimately, but you've never really seen it from that angle. Probably, hopefully. Although it's dream come true for certain people, I'm sure. Yeah. Did she write about this for Vogue? Could she get it out of her mind? Of course not. So it was kind of lodged in the back of my head. And I'm like, someday I will write about that video toilet. I will sit on that video toilet. Fast forward many years now I'm writing books. I'm looking around for an idea. And I'd come across the bed rest facility, which is a very cool place where people are paid to lie in bed for months. It's like an analog for losing muscle and bone in space. You know, you kind of create those situations and they can find countermeasures and do tests. Anyway, weird place. So now I have two chunks, two chunks, nuggets. And I'm like, what's the book that goes around this? So that's how packing for Mars. Because it's sort of, I sort of realized that what happens here on Earth in terms of NASA is kind of more interesting than what happens up in space. But that's usually how it happens. You know, it's rare that I have a desired to write a book about a certain topic. There used to be these ads for Kohler Faucets. It's this faucet company. There's this ad where this couple comes into an architect's office with a Kohler faucet and they put it on the architect's desk. So what can I do for you? And they go, design a house around this. I don't like what assholes. But anyway, like the toilet was my Kohler faucet. It was the seed build a book around this. What was the seed, the germ of the replaceable U? The Kohler faucet. Yes. What was your Kohler faucet for a replaceable U? Yeah, the Kohler faucet for this one. I'd been thinking about fat as a topic. I didn't go in that direction, but I was speaking to this woman who actually works in a stem cell lab. Leah Bellis is her name. She was, we were just sort of talking and bouncing things around. And in the course of this conversation, she told me about a surgeon who had taken a man's middle finger and constructed a penis using the finger. And I, of course, imagined just the finger being taken as is and put that, and also, which is quite anatomically improbable, thinking that it had been hooked up and that the man could now kind of like, Beckham. Come over here. Come over here, baby. And of course, that's not true. It was used inside some skin as a rigidity element. But I'm like, I will meet this man. I will go there wherever this is turned out to be in Tbilisi, Georgia. This was in the nation of Georgia near Turkey in Armenia. And in replaceable U, Mary notes that instead of commercial penile implants supporting the rigidity, it's the patient's middle finger and that the digit is skinned, but otherwise implanted whole. And Mary continues describing a sort of skin log lying in a small surgical basin. And she wistfully notes, quote, I'm reminded of a Vienna sausage, a canned meat product I enjoyed as a child, the same approximate color and circumference, the same blunt ends. And then it undergoes a second and more cosmetic follow-up surgery and then a life of a penile satisfaction and probably a lot of boner jokes. But no penicure, no nail on it though, right? They take the nail off? No, well, it seemed to me that the whole finger, is that a phalange? What do you mean, phalanges? How, the metatarsal something. Thank you, metatarsal, yeah. Okay, so the palm bones are actually called the metacarpals. But in this case, the phalanges and then after the wrist bones area of this gentleman's body got a promotion and they got a job transferred to a down south. Anyway, the whole thing, not just the bone, you know, with skin from often here, inside of the forearm gets used because it's hairless. Although in this case, there was some hair there, but I'm getting ahead of myself. We've all been there now? Yeah, exactly. So, yeah, it's basically like finger, wrap it up, kind of a pig in a blanket scenario. But, you know, I saw the final product and it was very realistic. Yeah. And it could bend up, like you could, you could bend it up. It was like a Gumby thing. That's handy. So, he can put on his pants, he can sort of bend it, fold it out of the way. It was more of a convenience situation. Like those razor shooters, popping the backpack, you're out of there. Exactly, or a Murphy bed. Yeah. Out of sight, out of mind. Yeah. One thing I love about all of your books is how much we get to like tag along with you and the taxi drivers you talk to. And the receptionist that you talk to and what the lobby looks like. And I'm always wondering how you can capture these moments with all of these different scientists in labs and, you know, smearing pesto on Fakata. How are you recalling everything? Do you have like a secret, those Ray-Ban spy cameras? Do you have a videographer? How are you recalling all of it? Well, I am always doing a, what is that the Brits say, belts and braces, right? So, yeah, like a belt and suspenders. I have a notebook and I'm writing down the things that I see and what's going on. But if it's a situation where interesting things are coming my way verbally quickly, I turn on a tape recorder. And if things kind of wander off in a direction that isn't interesting, I sort of subtly turn it off. Because I don't want to transcribe that shit. I still transcribe stuff. It's a weird thing. I still want to hear. I mean, I know you can do it with transcription stuff, but it's still documents too long. I edit as I go. And anyway, so I'm recording, I'm turning it off and on, pausing, on pausing. I tend to forget to take photographs, but I've gotten better about that just so I can remember what somebody looks like. But I'm not, you know, shooting the whole room or anything. You don't have a tripod with like a influencer style just video rolling? No, I don't. If people have said, you know, well, why don't you do, you know, you could be shooting video as you go and there could be a TV show. And I'm like, that's, no, I don't want to be the person going, let me stop you there. The lighting isn't very good here. And can we start over? You know, I can't because the moment's gone. Yeah. What if that happened right when the woman in the office in Tbilisi had, you know, been showing me the slide of the penis sort of bento. It was actually holding a ceramic water pitcher. Like what if I had to go, oh, can we take that? Can we do that again? I don't know. It's just because it was a smoke. I was like, oh, wow. Look at that. So in Replaceable U, Mary offers more details writing that this hand painted pitcher is white with a red and green floral pattern. And she envisions the man maybe pouring iced tea for a lover. This jug dangling from his member and she continues, it's not full, says the surgeon. He means the pitcher. This is just to show the resistance. It's very strong, effectively penetrative, she concludes. She's just, this is just a day on the job for Mary in the caucus mountains. You always tend to travel for your books and this one took you to Mongolia to talk to eye surgeons. How much time are they giving you before they'll let you see an orthopedic surgeon hammering into someone's knee or jamming a cataract out of an eye? Like, does that usually happen on the first day or do you have to charm your way into that? No, I make sure ahead of time to let people know that I need to have something to see. You know, I just am very straightforward. It's almost like I'm scouting locations for a documentary. I need place. I need people. I need conversation. I need things happening. You know, a PowerPoint is of no use to me. Get it out of here. I have a zero tolerance policy for PowerPoints. I need stuff going on. What do you got? What's coming up? What can I see? You know, sometimes that's been difficult, you know, for my third book, Bonk, which had to do with the study of sexual physiology, people researching sexual physiology. Well, that means people coming into a lab and, you know, being aroused and having orgasms. And, you know, and then I'm like, oh, can I be there with my notepad and my tape recorder? It's like really awkward. Or in your case, can you get in an MRI and bone? Yes. Yeah, yeah, it was actually ultrasound, which is even worse. At least with an MRI, you would have some privacy, right? Just like the guy with the white coat with the wand, the ultrasound wand on my belly and my husband is behind me. And that's really like, I can't even believe. I can't even believe that we did that. I mean, it's a while ago. I was 2008. But at the time I thought, this is going to be really fun to write up. And it was incredibly awkward and embarrassing and weird. But at the same time, I was like, this is going to be a fun chapter. And to enjoy that chapter in its fullest, you can see her bestseller, Bonk, the curious coupling of science and sex, in which she describes a research physician beginning with taking still images for which, quote, we must hold still for several seconds, like Victorians posing for a tin type, only not like Victorians posing for a tin type. She continues that the doctor says, now please make some sort of movement. And then in case it's not clear, in case her husband might be contemplating flapping an elbow or saluting the flag, the doctor adds, in and out. The doctor is pleased with this result. Again, this is from the book Bonk, in case it's like not already in your shopping cart. No one quite hops in as much as you do. And you even go in an iron lung in this book, which was a really heartwarming story. But what I loved about reading this is it runs the gamut from just tissue and cells to mechanics and having to rely on these machines. When you were writing it, were you trying to kind of parse out if this was going to be a book more about machines and what they could do or more about cell cultures and what we can do on a cellular level? Or was it all just sort of like, let's try to fix what's wrong? It was a situation where I initially really didn't want to go into stem cells and bioprinting. It's just, it's very complicated. And I don't have a background in genetics. Even if I'm a liberal arts major, and I'm like, I don't even know if I want to take this off. You know, science is like the era of bodies on slabs is gone. We're talking protein receptors and genomes and things that can't easily be described visually for people in the way that I like to do it. But then, you know, you immerse yourself in a topic and very quickly realize that's absurd. You really have to cover that to some extent. So initially, I'm always more interested in the human elements of things. You know, this book, in addition to the finger, I had also around that time, the other co-leur faucet was, I'd gotten an email from a reader, Judy Berna, who said, your next book needs to be about professional football referees, which made no sense to me at all. I don't watch football. I never talked about football. Anyway, that was what she thought. But we started communicating because I wrote back to her because I was intrigued by why she thought that. Anyway, she happened to mention that she's an amputee. And I said, oh, well, what's new in the world of amputation? And as one does, and she said, well, I'm actually, I'm an elective amputee, elective amputation, meaning somebody who makes a decision or wants to have a limb cut off because it's not performing. It's functionality is compromised, but it is a healthy foot or hand or whatever it is. And so it's very hard for her to find a surgeon willing to take off her foot. Mary writes that she has found herself at the Amputee Coalition National Conference. And she quotes a passage from the memoir of Judy Berna, who is an elective amputee born with spina bifida and having complications with her foot that twisted as it grew. Mary writes that her childhood was dense with surgeries and stubborn infections. And then in her memoir, Just One Foot, Judy writes, my foot had become a science experiment, a mess of flesh and bones, but few working nerves. And Judy told Mary that even though this foot exhausted and limited her, she'd watch people with prosthetic limbs managing things she struggled with. But the surgeon said, like, no, we want you to keep it. Because it's just like this is healthy tissue, you know, and it's like there's a finality to amputation. You're not going to put that foot back on. And she, it's been a long time trying to find somebody who would agree to take it off. And I thought that was really interesting that we don't have the power over our own bodies in that way. You know, it also has to do with that bias for wholeness, the sense that you're just better off with all your parts, especially if we, on the outside of all this, if we see you, we want you to look whole, that kind of thing. And it's absurd. You know, she's much better off. And there's a lot of people who have like foot drop or things that cause them to kind of shuffle. They can get around, but they can't run. They can't hike. They can't do things that they want to do. And particularly with a below the knee amputation, the things that you can do, you could get all these different attachments for different sports, you know, you can pretty much do whatever you want to do. And I think that you touched on it really well in the book of, well, don't you just want to print another leg or don't you want to do something that looks much more lifelike rather than what's more functional and how that's much more for the comfort of the people around them? Like, can you not look different than me because that freaks me out? And meanwhile, it's not as useful or as handy at all. Oh, yeah. I mean, think back to the artificial limbs from the earlier half of the 1900s that just, well, even probably into the 60s and 70s, those flesh tone, stiff kind of mannequin parts that people were using. You know, the whole idea was to pass, you know, that somebody couldn't tell. And now people go around wearing shorts with a blade, you know, just a tech thing that works. The functionality is what matters. So it doesn't matter what materials. And now it's kind of, I think, developed its own cool to look a little bit bionic. I think it's much better time to have a prosthetic leg. Mary explains that there are rock climbing feet. There are blade shaped prosthetics for running, basketball and soccer. There are surfing feet, swim fins, pivots for kayaking, handlebar adapters for mountain bikes. There are TDs for archery, lacrosse, tableted as basketball, fishing golf, ice hockey, softball, baseball, uneven bars, martial arts, billiards, volleyball, bowling, weightlifting and cricket. And there's many more for artists and other occupations, she writes. And there's also engineers working on whatever needs might come up. Also, a TD is a terminal device or an end of limb prosthetic for limb loss or limb difference. I also loved how because you went to that conference, you were sort of embedded there and you were able to do that. And you were able to tell your readers, this is like the nomenclature they use now. This is kind of the vibe like, here's questions not to ask. You sort of exposed through your own experience how people in that community would rather interact with people, which I thought was very helpful to someone who wasn't familiar with it. You know, you also went to a pig hospital, essentially, like in terms of Xeno transplantation. Was there any parts of writing this book or any parts of looking at replacing human parts that really freaked you out that you had to get over the eye surgery or like a beating heart cradled in your hands or freaked you out? It's pretty hard to freak me out, Ali. That's really like the freakier it is, the more I'm just, wow, this is so cool. I guess what was a little freaky to me was this idea, okay, you mentioned the pigs, Xeno transplantation. That's been a project ongoing for 30 years now. The effort to genetically tweak a pig so that its organs don't create a reaction, like an immune reaction, a hyperimmune response. If you were just to take an organ from a pig, put it into a person, the body just goes on the attack, like shuts it down. It turns black, it's gone. And for some very recent research on this, from late August, you can see the article in Nature titled, Pig to Human Lung Xeno Transplantation into a Brain Dead recipient, which reports a case of pig to human lung Xeno transplantation in which a lung from a six gene edited pig was transplanted into a 39-year-old brain dead male human recipient following a brain hemorrhage. And further studies are necessary. But reducing the risk of, say, endogenous pig retroviruses busting into human hosts like horror movie and our own immune systems trying to evict this precious organ, these tweaked genes are the key. And so they've taken that away. So now there's still longer term issues, but the place that we're at is you can buy a couple months time. There is one man who has got, I think it's a kidney and it was like five months as of June, and he's still going. So if that would buy you enough time to be eligible for a human organ, that's pretty cool. Now, what I was going to say, what was a little skevy to me was I was talking to someone about, you know, well, what's the end point here? And they were talking about chimerism or, you know, like chimera, chimerism, chimerism, I'm not sure the pronunciation. Chimerism. But it's been done with rodents, to some extent, where you would knock out the genes that would create, say, a kidney, and then you'd put some human pluripotent stem cells in. And so now there's this empty niche where the human cells would kind of go, oh, this is where we're supposed to do our thing. And so you'd have a pig growing literally human organs. And then you could kind of have the term was that was used as your own personal pig. On reserve. Like the way people have a car out in back for parts, you know, like, or I was like, you know, with pizza, it's like the personal pie. And that was like a term a few years back, personal pie, like your own personal pizza. You'd have your like your personal pig and I'm like, I don't know about that. I mean, I feel bad for pigs in general. You know, there's like 160,000 pig farms in China. Isn't that many? We are eating just, you know, millions of pigs. So, okay, so a few more to produce organs. Why is that such an awful thing? It's not awful. It's just, it was a ski-vee. It's just very sci-fi, very much, you know, the matrix kind of the pod being used to create whatever the living people need. You know, they're plugged in. I don't know. Just, yeah, just your own pig and goop. You've got a pig somewhere waiting for you. Yeah, waiting for you to fail. Yeah, exactly. I am the architect. I created the matrix. I've been waiting for you. Have you given more thought to donating your body? I mean, obviously with stiff, we know what happens to cadavers and donating your body to science, but you also have a great chapter about tissue donation, which my husband has some donor tissue in his knee going strong for like four years. And for more on your garbage knees, you can see our genicular traumatology episode with Dr. Kevin Stone, who fixes those knees. He ended up getting a completing his black belt and jiu-jitsu. He never thought he'd get to go back. And I'm like, dude, you owe that family like a letter for sure. Like, you've got to send him a letter, like, especially now that like you did this thing you wanted to do. But, you know, and ethically, your kin have to sign off on it. Do you think you're going to be donating your body to science? What do you think? I sure hope so. I mean, that's my intent. I really believe in organ and tissue donation. The number I was given at CORE, the Center for Organ Recovery that I visited in Pittsburgh, they said 75 people can benefit from one organ donor. It's bone, it's skin, it's tendon, it's muscle, it's an incredible gift. And the follow-up question would be, so have you signed the documentation, Mary? If you signed the papers. Yeah. And I'm really, I feel terrible. I haven't. It has nothing to do with what I've seen. Having seen organs taken from a body and having seen tissue removed, to me, that's just another kind of surgery. Surgery is never pretty. You know, it's messy and bloody and things are being cut and removed, but that's, it's being done for a really good reason and good things happen. So there's absolutely no reason for me not to have signed those papers. Mary notes in Replaceable U that regardless of a person's wishes or the dot on their driver's license, tissue can't be recovered until the next of kin has answered the eligibility questions. Is it hard to get accepted, though? What if they get you and they don't want you? It is. It is. I was told by the folks at CORE in Pittsburgh, they're like, I think it was 90% of people don't make the grade. Yale has a higher acceptance rate because it's like, you can't, there's so many diseases that you might have had also lifestyle things. If there's any needles, like, if you had a tattoo, if you used needle drugs, if you had sex with any of these needle drugs, have you this, have you that? Did you ever have this disease or that disease? So they don't want a lot of people. But if you get rejected, your feelings at that point can't be hurt. This is true. Yes. But I wonder if your family stands by a computer waiting to see if you got into it, into CORE like they do with Harvard. Oh my God, she got in. She got into 75 more people. 75 more people. We're going to get so many letters. Yeah, I love it. Like CORE, they give the person who's getting the body part, the bit of bone or whatever it is they're getting, they give them the option to write a letter to the family. And I read some of those letters and they're so nice. They're so lovely. You know, you've made this huge difference in the life of, you know, my husband or me or whatever. And that goes to the family of the donor, which is lovely. And I hope that they all do that because what a great thing to hear from, you know, the person who got the body part. You got your Achilles heel or whatever. Yeah. Tendon, not your Achilles heel. Tendon. Your Achilles heel. I don't want anybody else's Achilles heel. Yeah, you got someone else's vice. Yeah. Oh, no shit. That is my Achilles heel. I cannot say no to tinned fish. It is my new Achilles heel. And I don't know where it came from. Oh, God. I also enjoyed, I mean, you have chapters on asses, boobs, so much. I did not know. Breathing intubation. You intubated a dummy for this. What does it sound like when you're in the operating room? Is it real squishy sounding? Well, the operating room that I was in for this book was an orthopedic operating room. So it sounded like a wood shop. Nope. Don't like it. They're literally power saws going. A reamer. There was a reamer going. Nope. Nope. And it was screaming out, you know, to get rid of the damaged cartilage and kind of prepare the surface where you're going to put the socket for the ball of the ball and socket joint. And then there's, there's a surgical mallet, which is a metal and it mallet. It sounds exactly like putting in a tent stake. Oh, yeah. So those are the sounds that you hear. I don't think I heard anything squishy sometimes if they're doing the laser cauterizing wand, there's kind of a cooked flesh smell. They smell like barbecue? He a little bit. Yeah. I remember saying the first time I smelled that to the surgeon, do you find that smell a little bit pleasant? What'd they say? He said, that's really morbid. And I'm like, I don't really think morbid is the right adjective for that. It pertinent maybe, inappropriate, wrong. I would say that it's very honest. And that's a good question. Thank you. Thank you. Can I ask you some questions from listeners? Yes, of course. Okay, of course. And before we get into human technomorphology questions with Mary, we're going to donate to a cause of her choosing this week. We're doing a double donation. The first is to the Amputee Coalition, which is a community, a lifeline, and a source of strength for over 5.6 million Americans with limb loss and limb difference. So whether you're newly navigating this journey, supporting a loved one, or looking for ways to give back, this is your space. The Amputee Coalition builds a future where individuals can live fully and without limitations. You can learn more and donate at amputeecoalition.org. And we're also supporting the United Ostomy Associations of America, which empowers and advocates for people who have had or will have an ostomy or a continent diversion surgery. And their mission is to promote quality of life for people with ostomies and continent diversions through information, support, advocacy, and collaboration. You can find out more and donate at ostomy.org. So thank you to the sponsors of Allergies who make those donations possible. Crisp, vibrant, and bursting with citrus. Villamiria's New Zealand Sauvignon Blanc is the perfect wine, made to be enjoyed on every occasion. Whether you're soaking up the sun in your garden, hosting a backyard barbecue, or unwinding after a long day, the zesty lime and lush tropical fruits are always delicious. Try Villamiria Sauvignon Blanc, a vibrant New Zealand wine that's perfect for every occasion. Available at all good wine retailers. Okay, so we've asked Mary about writing Replaceable U. But now Fancy Nonna asked, what materials would be used in 3D printing for prosthetics? I assume you can't use PLA or resin. Fancy Nonna adds. Definitely not thinking of self-printing and replacing my arthritic joints. And Turner Pierce wanted to know, printed organs and bones. What's going on with that? They said when I was applying to grad school a decade ago, they were using medical imaging to scan and 3D print bones for anthropology research. And they said they thought it would be so cool to look at a printed version of my bones or organs. But are they printing anyone's bones up to replace your own bones? Did you see a lot of 3D printers? I spent a day and a half in a Carnegie Mellon has a 3D bioprinting lab. It was super interesting. They were not printing bone, but in general, extracellular material like collagen and things that don't need to be fed. If you're printing an organ or you're printing skin, you need to feed it. And it's like, what does that mean? You're going to print the capillaries? You're going to hope that the thing grows its own capillaries, which the body is really great at doing, up to a point. So that's kind of what they're trying to tease out. How much do we have to print versus how much can we let leave to the body to do to kind of create on its own? There are 3D printed, probably titanium bits and pieces of bone that take the person's MRI and match that way. But those sorts of things for sure are being used in addition to bits and pieces of cadaver, donor bone. So they are doing some amazing stuff with artificial materials for broken, bashed up joints, bones. It's funny to think that somewhere right now there's some place going to doot, doot, doot, doot, doot. What I mean? And there's just a bone rising from the plastic or whatever. If you're not using plastic like that, if you're using squishy material, that whole process of eat, eat, eat, eat, eat, eat, eat doesn't work well because it's squishy. You need a solid base that you're building from the bottom up. So you really can't do it. It would be like building a cathedral out of tofu. You can't do it. do it. So the researcher, Adam Feinberg, had patented this method where they'd have a support gel. You've got this gel that you're printing it inside of, and that is supporting the stuff that you're printing so it doesn't go all woodgy wumpas and wiggly. And then you'd heat it up, and then the support bath melts away. It's not printing a brochure. I mean, it's similar. You've got different extruder heads, and there are different kinds of bioprinting. I was just looking at this one. Extrusion method, which is kind of similar to the kind that you described. But like frosting of different viscosities kind of. This is going to prop this up and feed this, and that goes away, but this stays. Right, right. Exactly. Plazatron, a bit sci-fi, but do you think big brands will start producing body parts where you can get the latest installation so it becomes a fashion statement to have the latest update, like our iPhones, essentially? Do people working in this sphere, are they looking that far in the future, or are they really just looking like, can we get this thing to market? Can we prove that it works? You know, when I was in China, I was talking to the guy who's been working for 30 years on Xeno transplantation, having these organs available. And while I was there, before I left, rather, I was on this, there's some pig news website. Of course there is. What's it called? I can't remember. It's got a great name, like Pig Progress. It's Pig Progress. I was going through back issues of Pig Progress, and I came across there's a 26-story pigory in China. 26 stories of vertical farming, and there's this elevator that can lift like 26 tons, and there's pig facial recognition. It's just kind of an amazing thing. So having a conversation with Xiaoping Dong. Anyway, I was having a conversation with him, and I said, right now we're talking about trying to get one organ in one person to last six months. But I was like, what's this going to be like? We're going to have like 26-story pigories that are like churning out organs. They're going to be for organs. And he goes, yes, that is the future. You know, that was, he was very enthusiastic. But then, you know, the other side of that is I spent some time at a stem cell biotech company, you know, and I was like, well, you know, how far in the future, where we can grow from scratch, just grow organs. That's science fiction right now. So the other thing is that things are changing so fast that the future that you would have predicted two years ago has changed direction. There's ways now where you can take somebody's say blood cells and regress them to pluripotency, where they're kind of like that. They've got the potential to become anything, and you can instruct them to become a different kind of cell. And the hope is that one day we could grow whole organs. But right now, you know, you're just talking about clusters and patches. You know, you could create some dopamine producing neuron cells that would help someone with Parkinson's. But creating a whole, say, liver is way off. Yeah, that's a big job. Printing it or growing it from scratch. It's a way off. But what I'm saying is, okay, the pluripotent stem cell scene, sort of you take one person's and you regress them and then you train them and then you put that into one person. It's a bespoke process. It's very expensive. It's not going to be covered by insurance anytime soon. But what the hope is, is that there could be kind of off the shelf, preregressed pluripotent stem cells that evade the immune system that called stealth cells. Ooh. So pluripotent, side note means that a cell is kind of a blank canvas. It's down to become a lot of different kinds of cells and tissues. And scientists are working on making these pluripotent cells for the people off the shelf options instead of custom. So it's kind of like portée instead of couture. And in that case, you wouldn't have to take each individual patient, you know, take some blood cells, regress them, train them to become something else and then put them in. You know, you would skip the regression. So you'd be ready to go with these, you know, off the shelf pluripotent stem cells. So everything is changing so fast that predicting what's going to be out there is really hard. What's not changing fast is history. And Mary covers the first silicone breasts, like syringes, just willy-nilly raw dog, straight into the flesh, and also looks at techniques that have been used for years as she chats with a cedarsine iurologist about vaginas over Italian food. Mackenzie W, first time question asker, wanted to know, in what ways can this field provide gender-affirming care? And are there applications for technology that can help trans folks? And I feel like you did touch on that in the book. And, you know, was a lot of that surprising to you or was there something from that that surprised you or that left you thinking differently? You know, I just covered one particular procedure, which isn't, it isn't very commonly done. I had dinner with the director of the cedarsine i transgender surgery and health center. He's a urologist, a surgeon, and we met at an Italian restaurant across the street from the urology tower, and he was explaining this procedure, which is done sometimes if the more typical operation for a trans woman doesn't work out. And the more typical operation is to kind of invert the penis, you know, to do it that way. But if that hasn't worked, you can actually take a stretch of the colon and use that. And I was just fascinated by just kind of the surgical creativity, you know, that somebody would go, well, I don't know, a colon, it's a tube, it's stretchy, it's moist. I don't know, maybe that would work. Let's give a shot. Yeah, and that's actually not that new vaginoplasty using the intestinal tract has been done for, I think the earliest one was in the late 1800s, maybe it was early 1900s. But anyway, it's been around a while, but it's been finessed quite a bit. I was fascinated in kind of the amazing flexibility of the human body, you know, you could take this organ that evolved as a digestive organ and turn it into a sexual organ, and it works well with surgery. If you don't have an FDA clearance procedure is sort of like, well, if you've done something similar, and you have an idea to kind of change it a little bit to modify it, and you explain it to the patient, you just do it. I was just kind of blown away by kind of the resourcefulness, you know, and the, well, what do we got in there? We got, say, well, here's this kind of tubular thing that could be a vagina. And I was like, whoa, does that, you know, peristalsis, you know, the muscle, the contractions that move food along, I thought, well, that could be kind of sexually exciting. And he's like, Mary, no, that's a subtle contraction, that does not, not part of the advantages of. Was he like, good thinking, though? Yeah, I was also, I said, you know, when you're doing a vulvaplasty, say, with a vaginal plasty, I said, so the placement of the clitoris, you know, I know from a previous book, there's a fair amount of variation in how far the clitoris is from the vagina. And there's been greater orgasmicity with the closer it's located. I said, have you ever thought of just putting it really close? That's a great idea. As there's some animals where it's almost like inside and the vagina. And I was like, well, that could be kind of, kind of great. And he's like, you know, he was like, he was very nice. He was like, good idea, Mary. I like, I like that idea. But no, we said for one thing, you know, trans women often, they want to look normal, you know, they want it to look the way it should look. And there is a certain amount of variation with the placement of the clitoris, but not so much that it's like inside that. And he said also with a neo vagina, there's a certain amount of dilation that has to happen after surgery and some douching. There's to have a clitoris right there would be uncomfortable. What's the answer? I thought it was a good idea. Yeah. Oh, but that's very creative. Alex Minor wanted to know, in all your deep dives into the strange corners of science, what is a bizarre factor moment that didn't make it into a book, but still lives kind of rent free in your brain? And I don't know if there's NDAs that are involved here, but if you can spill whatever you spill, I'm all ears. Okay, I love this question because there is a fact that I learned not that long ago that isn't in any of my books. And here is the fact. Okay. Okay. When you have a murder victim, and you're trying to determine the time of death, and you're looking at the insects, right? Like how, how far has the body degraded? And you're looking at the insect life and the maggots, et cetera. If the person had been on cocaine, you have to adjust your timeline because the insects feed really fast. No. That's what I was told. They're like, let's get this done. Let's get this. You know, if you're actually hungry, I'm really gotta wait a little bit. This is really good. This is really good. Isn't it really good? Let's keep eating. I'm just not even tired. I'm just not even tired right now at all. That's, isn't that amazing? That's bonkers. But anyway, good for them. I don't even remember where I learned that or who told me, but it was a science person. Of course. It was an oligest. So I invite you to see the 2022 paper, effects of cocaine and heroin and their combination on the development rate of califora vomitoria, which tossed some fly eggs into pots of minced pork and then just watched them grow up into maggots. So these lab-coded drug lords found that maggots seem to favor the effects of the cocaine. But yeah, this is all important because if you're trying to date a body, time-wise, how fast and how much these maggots develop could be affected by what kind of final weekend the corpse had had. And if you're wondering how the flesh-loving bottle fly got the name califora vomitoria, it look, I look this up and it seems that the site of maggots all over butchers meat, pre-refrigeration, was just enough to make people straight up hurl. So they named the fly califora vomitoria. And we do have a fly episode for you with fly enthusiast and dipterologist Dr. Brian Lassard. And if that is not creepy enough, we have an osteology one about bones and body farms. And if that is not creepy enough for you, our October Spooktober series kicks off with an episode in a few weeks all about creepiness from a psychologist who studies creepiness. And not to suggest that Mary eats cocaine pork to work faster, but... Are you already working on another book? Because I feel like it's, I can't even imagine when a book comes out, you must be so exhausted. But do you have like four other books just in the wings? No, I wish I did. I don't have another book idea. And I'm always open to ideas if anybody listening wants to share an idea of... And it doesn't even have to be this kind of, you know, the kind of book that I do is a little exhausting. It's like 17 rabbit holes. I'd love to go down one long rabbit hole. It doesn't even have to be science. So, you know, if you have, if you've got an idea, something in your life that you think, God, Mary Roach should write about this. Let me know. No, I don't know what's next. I don't. That's the hardest part for me. I have a pitch. Yeah. What about, what about, have you ever thought of football referees? Oh my God. Steer me out. My friend Judy and I. That is brilliant. That is so me. You never know where it could take you. No matter what you write, I'll read it, obviously. I have a section on my bookshelf that's just Mary Roach. In my library, of course. The last questions I always ask, I usually ask what sucks about people's jobs. Any rants you have about this book, anyone give you an interview and then say you couldn't use it or was anyone an asshole? You don't have to name them? With each book that I do, it gets a little harder to get access because people have liability concerns. I think for this one, I was turned down initially. I ended up going to the Extra Corporeal Life Support Laboratory, which is they look at devices that support the body outside the body like ECMO. ECMO, side note, I had to look this up, stands for Extra Corporeal Membrane Oxygenation. I should note also, while looking up what ECMO stands for, I happened to be listening to an old playlist that included the 1982 gothy synth track, the chauffeur. I was looking this up right as Durand Durand delivered the lyric and the droning engine throbs in time with your beating heart. Anyway, Mary gets to meet people who save all kinds of lives, human ones. Like the guy who invented ECMO, Bob Bartlett, runs the lab. Initially, the Public Affairs Office, they answered my email and then they just ghosted me. I was like, what? I kept writing to them. Finally, I called Bob Bartlett. I'm like, what's the deal? He's like, you know what? It's my lab. You just come here and we'll let you in. I go there and I said, what the heck happened today? He said, oh, the Public Affairs people were really concerned that you're an animal rights fanatic. Anyway, so there's a lot of weariness and nervousness. I get that people are worried about lawsuits. They're worried about social media. They're worried about everything. It's a time of being worried. I think that being allowed to go. I went to Chengdu, China because I couldn't go to United Therapeutics or eGenesis. The two companies here that are creating pigs that have more acceptable organs to humans. Thank you to both of them because I had a great time in Chengdu, but that can be very frustrating. I don't blame them. As my agent said, Mary, can you blame them? I mean, who wants Mary Roach sort of mucking around? Who knows what she's going to say? Who knows what she's going to do? What about your favorite aspect of writing this book in terms of places it took you or people that you met? I interviewed a rat expert about sewer rats once and I had one of those moments where it was just like, I can't believe that I get to do this as a job. Do you ever have those moments when you're working on something or just go, wow, lucky me? Oh, for sure. Yeah, for sure. So many of those moments. I remember when I was reporting for Packing for Mars, I was up in the Arctic on Devon Island, which NASA uses as an analog for the moon and Mars. And I had a week there when I didn't really need the whole week. So I just talked to a lot of people thinking, I don't know, I'll see what they do, these researchers. And there was a guy who studied, he was a suit guy, and he was working on creating an escape suit. So this would be a suit where if something goes wrong, either as the spaceship is going up or the capsule is coming down at any different altitude. And it's really tricky because depending on how much atmosphere you have, your parachute has no air to unfold or you're going to burn up. So it's a very tricky suit to create and system to create. Anyway, he's explaining it all to me and I'm like, maybe I'll write something about this. I don't know. And he had given me a mission patch. That's a patch that has the name of the mission, the number and all the crew members' names around it. And I didn't really, I'm like, oh, thank you. And it was for Columbia. And one of the names on the patch is Clark, Laurel Clark. And I realized in the middle of his explaining things, that his name is Clark. Like that was his wife. So his wife had died and that was what was motivating him. He believed that it can be survivable, that you can create a survival suit for surviving an explosion at altitude or a breakup, maybe not depending on the type of explosion. But that just changed the whole tenor of the conversation. And it was, you know, you have those moments where, you know, like Mark Randolph, the guy whose iron lung I had spent time in, you know, I went there thinking, this is a chapter about negative and positive pressure breathing and about iron lungs and what is that like? And, you know, and all of a sudden he was talking about his marriage to Mona and how hard, you know, everything that he'd done for her. And he was reciting when she wakes up in the morning and I take her from the iron lung to put her in the hospital bed. I use a pulley and he just recited all the steps. Like it was like a prayer, you know, like an incantation. And I realized sometimes what you think the chapter is about needs to scooch over. And you need to give this person room to talk about what it was like to be with her. And like, you don't always anticipate the emotional moments because I'm kind of a goober, you know, I'm just kind of like, well, I'm just out there to have fun and kind of find cool, interesting things that I can bring to readers. And all of a sudden, I realized I'm stepped into somebody's world and there's more to it than that. Yeah, that part of the book too was beautifully written and touching how later he was incorporated into the book and I won't spoil it for anyone, but really was touching. And I've always thought that the fact that you're a character in the book and your reaction is both delightful and also a proxy for anyone who can imagine themselves as you. But anything, right, I'll read it. So I mean, no pressure on the next one, but this book isn't even out and I tore through it in like a day and a half. It's such a good book. Thank you so much. That is so nice to hear because you're like the goddess of science communication. That's not true. No, but you find these people who have this passion for what they do and they're good at explaining it and they're charismatic and they're interesting and fun and you just bring that out in people and you get people to see what science is and it's not the slog that you thought it was when you were in high school, that it's so interesting and it takes people places and I don't know, you do that like no one else. I'm just copying you really. I just learned from the past. You ran so that I could stumble behind you and I really, really so appreciate getting to interview you even though it took three times and I'm so sorry about technical issues. No, no, no. But you are the best. I got all teared up talking about you. That's how much I respect you. I'm holding back tears. You have no idea as soon as I close this laptop, it's fucking over for my mascara. It's over. Really just keep doing what you're doing. You're the best and everyone buy this book. It's such a good book. You too. Thank you so much, Allie. So ask Eidol's questions of idiocy. I love Mary Roach. I love her work. There would be no allergies without her and icon. So thank you so much, Mary, for being on the show and do pick up any of her books, including Replaceable You, Adventures in Human Anatomy, which comes out today, September 16th, 2025, and then Collect-a-Mall, Stiff, Spook, Bonk, Packing for Mars, Gulp, Grunt, Fuzz. They're all good. Also, don't get her confused with the Mary Roach who was on American Idol, but we will link this Mary Roach's books in the show notes. You can find them literally wherever books are sold. Every single one is phenomenal. Donations, again, went to amputee coalition and ostomy.org. And if you don't want to hear about having sex under the prying eyes of an ultrasound, we have small g's episodes, which are shorter. They're kid-friendly edits of allergies. You can find those wherever you get podcasts or linked in the show notes. Join Patreon at patreon.com slash allergies, where we are posting social content there called quips, including an exclusive tour of the bugs that I keep in my freezer. We are at Allergies on Blue Sky and Instagram. I'm at Ali Ward on both. Thank you, Aaron Talbert, who admins Theology's podcast Facebook group. Aveline Malik makes our professional transcripts. Scheduling producer Noelle Dilworth scheduled this a few times. Thank you, Noelle. Susan Hale is the Irreplaceable Managing Director. Our mechanical breath of fresh air is Jake Chaffee and bleeding heart, Mercedes Maitland is our lead editor. Nick Thorburn wrote the theme music, and if you stick around until the end of the episode, I burden you with a secret from my life. And this week it's that when I wrote an article for the LA Times in 2010 covering Packing for Mars, and I got a chance to interview Mary then, I had a devil of a time turning the copy in. I was just in knots. I was terrified that someone I respected so much would read it, and it would be trash. And after it was published, she wrote me a really nice note afterward, and I printed up that note and I kept it on my desk for my more anxious days. If you even remotely tolerate me and you're not already in love with Mary Roach, you will be after one paragraph in one of her books. So enjoy. Okay, bye-bye. Seriology, terminology. Crisp, vibrant and bursting with citrus. Villamiria's New Zealand Sauvignon Blanc is the perfect wine made to be enjoyed on every occasion. Whether you're soaking up the sun in your garden, hosting a backyard barbecue, or unwinding after a long day, the zesty lime and lush tropical fruits are always delicious. Try Villamiria Sauvignon Blanc, a vibrant New Zealand wine that's perfect for every occasion. Available at all good wine retailers.