99 Ways to Die (and how to avoid them⁠) with Dr. Ashley Alker

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Hey, it's Zach. You're listening to Weirdly Helpful.

In this episode, it might not be suitable for young years.

In your illustrious career so far, can you list the things that you've pulled out of people's butts?

Oh, man. Papaya channel changer to light bulbs. Apple.

Full Apple? Yes, full Apple. Sunscreen? I mean, just the list goes on.

A lot of items that shouldn't be in butts. They make things for this.

Go out. Buy something that's safe with a stopper on it. Use cash. Wear a hat. Do what you got to do.

But just don't put household items in your butt because it's dangerous.

Now we're getting to some truly weirdly helpful. Don't put household items in your butt.

It doesn't matter to me how it got there. I think the most important thing is it doesn't create

a colonic perforation, a hole in your colon that then results in severe sepsis and death. That's

what I care about. My name is Ashley Alker. I am an emergency medicine doctor, medical director,

an adjunct professor at George Washington University. And I'm the author of 99 Ways to Die and how to

avoid them. We can't get through all 99 today, but we will do a handful of Weirdly Helpful Ways to

Avoid Death. That's in addition to not sticking your remote controls up your butt.

The lowest estimates are that a third of US homes don't have carbon monoxide detectors. The

highest ones are more around half. And so that means like a hundred million people in the United States

don't have carbon monoxide detectors in their home. And this is a colorless, odorless gas.

You have a fire alarm, so you know your house is on fire, but you can see that. And you can never

tell if there's a carbon monoxide leak until it's too late. The other thing that's kind of crazy

is only 14 states require carbon monoxide detectors to be in hotels and home rentals. And even

daycares, there's no federal requirement for these, these, you know, life-saving detectors,

which has led to carbon monoxide depoisoning in children in daycares, for instance in Pennsylvania

in 2022. This happened. And this, these, these are $20. They're super cheap. You can get it online,

you can get it at a store. You can travel with it. I often travel with one. So super easy. So

you know, you'll read at least a couple times a year about somebody on vacation who thought they

had food poisoning. And then the next day wakes up in a hotel dead and that's carbon monoxide

poisoning. So it's frequent enough that, you know, it's something that we should know about. And

it's avoidable, a hundred percent avoidable. Do homes need to have more than one?

Um, it's best to have them in places like near furnaces. So you have like early detection and

then near bedrooms and such. Um, are important too. But more than one is great because depending on

where the leak starts, you can kind of get a head start on it. And, you know, a little bit of

carbon monoxide in the blood, you'll see in like smokers, for instance, will have higher levels

of carbon monoxide by a very small amount. But, you know, it's best not to have any. So, you know,

I think that having it in multiple locations is great. But the most important thing is like,

for instance, we have one near our room and our baby's room. Yeah. And like you say in the book,

it's tasteless, odorless, colorless, like it's so scary. Yeah. So that's, that's a big one.

Okay. So there's the butt stuff. Get yourself a carbon monoxide detector ASAP. And this, if you wake up

and see a bat in your home, even if you don't think it bit you, their bites are painless and you

can't see them. It's like the carbon monoxide of flying creatures. It is. It's the carbon monoxide

of mammals. Yeah. So this bat, which is the number one carrier of rabies in the United States,

can basically bite you. You wouldn't know about it. And rabies, once you have it, is 99.999

percent fatal. There's one person in Milwaukee that was a little girl who survived it. We still

don't know why. Superhero. But basically, if you get rabies, you're going to die. Wow. So,

do you treat a lot of bat bites? In Virginia, I do. Surprisingly, when I was out in California,

I did not, there, I mean, there weren't a lot of like, I don't, maybe because it's a desert,

but there weren't animal bites in the same way. I treat a ton in Virginia. I give rabies vaccine

all the time and immunoglobulin out here, which are both recommended immediately upon exposure

to any bat or, you know, an animal that possibly has rabies, because it can prevent the virus

from attaching to the nerve. And once it's attached to the nerve, it's game over.

How long does that typically take? So, here's the really weird thing. It can be basically immediate

or it can take like up to a year. So, even if it's been like a month and you realize, hey,

I should have gotten post-exposure prophylaxis for this bite, you should go do it. Yeah.

Even if it's been a month or two or, you know, time has passed, go get it done because

it's a very weird virus. And we don't understand the reasons that it does some of the things that

it does, but we know that post-exposure prophylaxis is very effective at blocking that connection

between the virus and the nerve, because the immunoglobulin basically goes and it blocks it while

the vaccine makes more antibodies to block it, moving forward like months, years in the future,

etc. You book you mentioned like being a vaccines are since you were a kid. Is that right?

I don't know what's up with the boomer generation, but they exposed us to some weird stuff,

or at least my parents said, when I was, I don't know, maybe five years old, they showed me the

movie Old Yeller. Did you ever see that as a kid? I never actually saw it. So, maybe it was just

my parents. Okay. So, it's a movie about this, you know, young family and they have a dog and the

dog is the best dog in the world. Is this yellow lab named Old Yeller? And we had a yellow lab,

who I loved dearly as a five year old. And the whole story is basically about how this dog is

such an integral part of this family, and then gets rabies protecting the family from a rabbit wolf.

It was lucky for us son, but it wasn't lucky for Old Yeller.

Shoot up somebody in bad herd. No wolf in his right mind would have jumped us at the far, not even a

local wolf. That wolf was mad. And one of the kids has to shoot the dog. And I'm like, what is the,

what is the, you know, lesson here? And basically what I took out of it was, you know, rabies is

bad. We all should get vaccinated for rabies. So, I would go around asking kids if their pets were

vaccinated for rabies. And, you know, made sure my dog was vaccinated for rabies.

We can't just shoot him like he was nothing. Don't you want to stand?

Another one that's super common that's, you know, we've all had is strep throat. Definitely.

So most people don't know that strep throat can kill you. And it's something that killed a lot of

people historically. It causes rheumatic fever, which is a heart disease. It causes, you know,

scarlet fever. It causes, it can cause a toxic shock syndrome. And it causes something called

post-streptococcal glomular nephritis. So these are all things that you can get after a

strep infection. And a lot of them are prevented by antibiotics, which is why we don't see rheumatic

fever or scarlet fever anymore in our populations in the same amounts. And we don't see it killing young

people the way we used to. And that's simply because it's tested and treated for. But because of that,

people, you know, our memory of the fact that this thing is dangerous and needs to be checked for,

it kind of goes away. And we forget that it's dangerous. And so we ignore it sometimes. And so

that's another thing that, you know, if you have a sore throat, get checked for strep. That needs to

be treated. And take your full course of antibiotics. Yeah. And don't take old antibiotics. And,

you know, I think that people don't know that bacteria and antibiotics are like a lock and key.

So if you have leftover antibiotics, like let's say you have docks of cycling, but you have a

urine infection, that's not going to do great. So, you know, you have to be on the right

antibiotic. Strep throat is treated by, you know, our oldest antibiotic penicillin,

esophilis porins, augmentin, you know, which is also a penicillin. So the point being is that you

have to take the right antibiotic. So don't guess because if you're taking the wrong antibiotic,

it's, you know, cipro isn't going to be very helpful. So in that situation was strep throat.

Yeah. Yeah. So the right antibiotic, the right course and for the right reason, which is bacterial

infections, not viral infections. So viral infections are, you know, best defense against viral

infections is generally when we have it vaccines. So I think people, you know, know that flu and

COVID are something that are very common, but other than just being deadly, I don't think they

understand the cost to society. So we're talking about, you know, just for influenza this year,

11 million people, you know, sick, 120 hospitalizations, over 5,000 deaths, including nine

pediatric deaths from flu. And COVID, I mean, it was the second leading cause of death in 2021.

So obviously, we know that this can be deadly as well. Super simple. Get a vaccine. It reduces

hospitalization, number of people sick at the cost to yourself, your family, society, and it

reduces deaths. And I think that it's just as important to know that and maybe even more

important at this point in time, how and how childhood vaccines work and how important they are,

because we have had vaccines for long enough that they've eradicated a lot of these diseases in

the US or had eradicated a lot of these diseases in the US. We don't understand the pain anymore

because we haven't seen it. We haven't been in it. We haven't watched our children suffer from it.

So we don't know as a society what diphtheria looks like, what measles looks like, what

whooping cough looks like. But now whooping cough and measles, they're coming back because people

aren't vaccinating. The Lancet did a study that was really interesting about the last 50 years.

And vaccines have saved over 154 million lives. That's six lives a minute for 50 years. And 101

million of those lives were children's infants. In our society that you need to protect and you

never want to see die. So I think that we have gotten to a point in our society where our privilege

has obscured our view of reality. And it's causing us to step back in our health care and everybody's

worried about wellness. This is one of the most important things you can do for yourself and your

child as far as wellness is concerned. You're worried about taking supplements and all this,

you know, even eating healthy. These are things that are long term that are going to, you know,

possibly be good for you. Vaccines are something that are good for you right now.

There's something that are going to protect you and your family in this moment. If you

die from measles next week, who cares if you ate an apple for lunch, you know? So I think there

just needs to be a reality check in our society about how important these are to the success of your

family, your community, your country. And I think that we need to kind of, we're letting everyone

have a voice, especially on social media about these things and some of these people have no idea

what they're talking about. So I think it's time to look to experts and look to the people you trust

like your primary care doctor. If you have that, you've seen hesitancy discuss it. But that's the

most important part of the book, I think, as I discuss what these diseases look like and what they

did and the lies that they took, because it's a reality we need to understand as a society.

Have you seen measles? I have not. I was raised in a time when measles vaccine was given and

basically eradicated it from our society. And unfortunately, it's back. The biggest outbreak we've

had in many, many, many, many years. And, you know, I probably will see measles in the next year or

two, unfortunately. And it's something I never wanted to see and I didn't have to see and I don't

want to see it because I don't want to see someone suffering unnecessarily. That's the worst part of

it is that you look at the situation that they're in and it's completely preventable.

Dr. Ashley Alcker is the author of 99 ways to die and how to avoid them. I want to thank you

for coming on the show for this wide-ranging conversation. After the break, we started with butt

stuff. We're going to end with butt stuff. But first, you should consider becoming a weirdly

helpful patron so you can listen to the show ad-free. Do that by going to patreon.com slash weirdly

helpful. That's patreon.com slash weirdly helpful. It is the foundational ways to support my weird

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Starting something new isn't just hard. It's terrifying. So much work goes into this thing that

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at Shopify.com slash best advice. Years ago I took a walk with a gastroenterologist and she

told me something that really put me at ease. I hope it does the same for you. If you could tell

everybody who poops one thing what would you tell them? I think if I could just tell them one thing

it would be that there's no right number of bowel movements to have. I think a lot of people get

sold this kind of bill of goods like you need to have one perfect bowel movement a day that should

look like a snake made out of toothpaste and if you don't do that then there's something wrong with

you. But really and truly there are lots of people who who more than that less than that

different consistencies and that may just be their normal. So yeah I think that would be the thing

that I would tell people. That's gonna put so many people at ease. I hope so. I'm gonna put so

many butts at ease. Yeah exactly. Hopefully. You know there's definitely stuff that we tell people

watch for in their food. You know like blood is not a normal thing that should be in poop. Black

tar like poop can sometimes be blood that's been digested. You know these are things that I want

people to know that they should be concerned about. Most the time is just a sign that the body is

doing what it's supposed to do and that's a wonderful thing. Can you introduce yourself to

me who you are and what you do? Yeah I'm Kira Newman. I'm a physician. I'm towards the end of my

training for gastroenterology. So I study poop pretty much all day every day. Talk to people about

their poop and help them problem solve and their poop's not doing what's supposed to do. You got us.

I wish the people paid a little more attention their poop sometimes. So I think that

people don't give it the appreciation that it deserves. How do you mean? Well I think we spent

on this time thinking about like oh you talk about evolution like the magical evolution that gave us

eyes that are capable of seeing. But we all have these guts that are capable of taking all kinds

of things from the world and turning them into nutritious things that build an entire human being.

And nobody appreciates it. Take a moment to be instead of grossed out. Be kind of excited and be like wow

my body just did something really cool. Like my body took all the stuff that I ate and broke it

down and turned it into fuel for me. Oh that's pretty rad. Yes. So I hope that people can appreciate

a little bit more. Just think like hey my gut did this for me today. It does it every day.

Doesn't ask for a lot. Doesn't necessarily look like the prettiest organ on your body. But

it's it's pretty marvelous. Thank God. Yeah thank God. Thanks Kira. You're welcome.

I want to thank my medical brain trust Dr. Ashley Alker from the first segment and Dr. Kira Newman.

I would love to hear what you are finding weirdly helpful. It makes my day when anyone calls

the hotline. Call me right now. What do you find weirdly helpful? 844-935-2378 that's 844-935-2378.

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