Poverty, the Thymus and Sudden Infant Death Syndrome

Friend of the Order Chad Weber gives us the highlight reel of Stanford neuroscientist Robert Sapolsky’s lecture “Poverty’s Remains.” The lecture is available (for a fairly large sum) on the Great Courses website, and some of Sapolsky’s free lectures can be downloaded here.

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Because of society’s death-phobia, historically most people did not want the bodies of their loved ones to be autopsied. As a result, anatomical knowledge came largely from the dissection of the bodies of the poor, who were buried in shallow graves in Potters’ Fields or just left at the hospital to be bought up for study by colleges.

Science-Anatomy-Dissection

Being poor alters your anatomy in several ways; one of these markers is found in the thymus, which shrinks in response to stress. A stressful week decreases thymus size by 75 percent, so imagine what the constant, chronic stress of poverty would do. As a result, physicians thought that the shrunken, abnormally small thymuses of the poor were the actual size of normal thymuses.

thymus

Enter Sudden Infant Death Syndrome. Because SIDS is defined as the death of a previously healthy baby, and because extremely poor babies are generally unhealthy, SIDS is basically a condition limited to middle- and upper-class babies. At the time, poor babies dying was not unusual enough to merit special attention.

When doctors began dissecting babies who died of SIDS in the late 19th and early 20th centuries, they found these well-to-do babies had big thymuses. Of course, these “big thymuses” were actually normal-sized, healthy thymuses that had not been shrunk by the stress of poverty. But the doctors compared them to the thymuses of the poor they had autopsied and said “Aha! SIDS is caused by an enlarged thymus! These enormous thymus glands are compressing the babies’ tracheas while they sleep, suffocating them!” They even came up with a name for the supposed condition — Status thymicolymphaticus.

medexpt
With the discovery of radioactivity and its potential medical uses, a treatment for Status thymicolymphaticus was devised — simply irradiate the baby’s throat to shrink the thymus, thus saving him or her from SIDS.  The treatment became commonplace in the 1920s and ’30s.

Coloured SPECT scan of thyroid cancer

Unfortunately, the thymus is located right next to the thyroid, and the thyroid reacts to radiation by becoming cancerous. Only in the mid-1930s did doctors realize that the large thymuses were healthy thymuses and smaller thymuses are indicative of unhealthy stress levels. They then realized that not only did Status thymicolymphaticus not actually exist, but treating this nonexistent problem with radiation was unnecessary and potentially lethal. By the time the radiation treatments were stopped, over 10,000 babies had died of thyroid cancer as a result of the treatments. Part of the sometimes grotesque growing pains of modern medicine.

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  • CrankyAmy

    Actually, if you click on the individual courses (1 or 2) (as of today Jul. 10, 2013) you can get them rather cheap. http://www.thegreatcourses.com/tgc/courses/course_detail.aspx?cid=1686

  • HS

    And that is why we Americans don’t just trust doctors blindly anymore. They are human, after all.

  • Chad Weber

    Happily, the course (“Being Human”) which includes this lecture (“Poverty’s Remains”) is relatively cheap – about $30 depending on the format you choose.

  • Rowan Tree Design

    Another good one: it was discovered in the 1700s that if doctors attending childbirth washed their hands between deliveries, deaths by infection dropped by something like 70%. But doctors en masse refused to do it because they didn’t like the implication that they were dirty. Oh, SCIENCE.

    • Anonymous

      Dr. Ignaz Philipp Semmelweiss. That’s the doc you were thinking of.

  • Bill Woolley

    That’s me. I was born in 1953, was diagnosed with an “enlarged thymus,” and my parents had irradiated to shrink it and minimize the risk of SIDS. In 1978, I was diagnosed as having malignant thyroid cancer and had a full thyroidectomy. I’ve been taking thyroid replacement medication, daily, ever since. I’m profoundly grateful for Prof. Sapolsky’s explanation in this regard.