Deprived of food, our bodies do the best they can to keep us alive and functioning as long as possible. As the days pass, the rhythms of our lives change: our metabolism, our heartbeats, our hormones, even our thoughts shift to adjust to this period of scarcity. This response is evolutionarily engrained, following a variable but fairly prescribed path. In this episode, we trace that path, exploring what happens when our bodies are not given the energy stores they need, how patterns of metabolism alter, leading our bodies to consume themselves, and the profound consequences this has on every part of our physiology and psychology. We also tell the story of how we came to learn about these outcomes, chiefly through a WWII-era study called the Minnesota Starvation Experiment. This is the first of two episodes centered around malnutrition, starvation, and famine. Next week, we’ll explore the broad topic of famine, of which starvation is merely one component.

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The United States is in the midst of a monumental mental health crisis, with one in four people predicted to experience mental illness at some point in their lives. Adequate mental health care remains out of reach of so many due to a myriad of factors: unaffordability, stigma, shame, and racism, to name a few, leaving enormous gaps in mental health equity. The roots of these inequities can be traced back decades, to the earliest psychiatric hospitals founded on harmful racist notions of mental illness. In Madness: Race and Insanity in a Jim Crow Asylum, author and award-winning journalist Antonia Hylton explores the story of Crownsville Hospital, a segregated asylum in Anne Arundel County, Maryland, built in 1911 by its first patients: twelve Black men. Over the course of the 20th century, the shifting perspectives of race and mental illness played out in the overcrowded and understaffed Crownsville Hospital, with powerful implications for understanding our current failing to deliver adequate care to all in need. Madness is a powerful and necessary book that sheds much-needed light on the intersections between race, racism, and mental illness.

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Every year, millions of babies around the world are screened for dozens of treatable conditions within the first day or two of life. What it takes is a few drops of blood on some filter paper, and what it gives is profound: potentially life-saving information. The advent of newborn screening is one of the greatest public achievements of the 20th century; since their earliest implementation, screening programs have diagnosed hundreds of thousands of babies early enough for medical intervention. And the life-saving potential they hold continues to grow with the development of genomic sequencing technology, which will increase the number of screenable conditions by an order of magnitude. In this episode, we explore the serendipitous origins of newborn screening, what the process looks like from a parent’s perspective, and how cutting-edge technology could revolutionize these programs. To help us navigate the exciting future of newborn screening, Dr. Joshua Milner, Professor of Pediatrics and Director of Allergy Immunology and Rheumatology at Columbia University Medical Center joins us to discuss an ambitious research program at NewYork-Presbyterian hospitals titled the GUARDIAN study, or Genomic Uniform-screening Against Rare Disease in All Newborns. Tune in for a truly thrilling episode!

For more on the GUARDIAN study, the groundbreaking research program using genomic sequencing technology to screen newborns at NewYork-Presbyterian hospitals for hundreds of conditions, check out the Advances in Care podcast episode titled “Newborn Gene Sequencing: Expanding Early Detection of Treatable Diseases.”

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