cover of episode The Department of Physiological Hygiene

The Department of Physiological Hygiene

Publish Date: 2022/9/22
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You can find Pushkin Plus on the Revisionist History Show page in Apple Podcasts or at pushkin.fm slash plus. Minneapolis, 1944. Busy sidewalks, miles of streetcar tracks, businessmen in gray suits and hats, shop girls in knee-length skirts.

The Mississippi snakes through the middle of the city. The Fauché Tower looms overhead. Overseas, the war in Europe and the South Pacific still rages, so many of the younger men are gone. But there is bustle and energy that makes the downtown feel like Chicago or New York City, unless you look closely and pay attention day after day. And if you did that, you would see a strange sight that set Minneapolis in that moment apart.

You would see men in groups of two walking the streets, early 20s, dressed identically in khakis and white shirts. They would seem healthy at first, but then as the fall of 1944 turns into the long winter and spring of 1945, you would see them start to change. You'd see them start to move slowly, as if they were old men.

Their clothes are one, then two, then three sizes too big, eyes hollowed out, hair thinning, skin like parchment. They sit in restaurants and soda fountains and drink cup after cup of coffee, but never eat, ever. Even if you invited one of them to join your table, they just stare at your food with blank eyes, then move on, shuffling down the sidewalk, across the Mississippi, and back to a warren of rooms under the football stadium at the University of Minnesota.

Back to the Department of Physiological Hygiene, run by a man named Ansel Keys. What does he look like?

Ansel Keys. He was short. You know, I think that bothered him a little bit. He was very muscular. He was very, I think, very good looking in his youth. That's Sarah Tracy, a historian at the University of Oklahoma, who's writing a biography of Ansel Keys. You know, he was a child genius.

He was one of Lewis Terman's 1,500 gifted children whom he tracked. He was a termite. Yes, he was a termite. You know about the termite. I do. I do. The termites were a group of children with super high IQs. You had to be very smart to be a termite.

He was very self-possessed as a child. You know, if he set his mind to doing something, he did it. He left high school three times, once to become a powder monkey in some mines, gold mines, once to become a lumberjack, and once to collect bat guano from caves in Arizona.

Ancel Keys was America's first true celebrity doctor. A mountain climber, an adventurer, he was on the cover of Time back when that was the real measure of celebrity. He wrote best-selling cookbooks with his wife. He had a fabulous villa near Naples. The army has developed the now famous K-ration, the completely streamlined meal. Back before the Second World War, the army came to him and asked him to make a high-calorie, pre-prepared meal.

It was called the K-Ration. K for Keyes, of course. And millions of GIs ended up carrying his creation into battle. Originally designed for paratroops, K proved ideal for tank busters, commandos, and all isolated units. Each package contains a balanced, vitamin-rich meal. With the K-Ration under his belt, Ansel Keyes then turned his attention to an even bigger question.

one that had long obsessed those who study human physiology. What happens to people when for months on end you deny them food? My name is Malcolm Gladwell. You're listening to Revisionist History, my podcast about things overlooked and misunderstood. This episode is about an audacious experiment conducted at the end of the Second World War by one of the most remarkable figures in 20th century science, Ansel Keys.

So for purposes of the tape, if you could just state your name and the location and date of your birth. This is Earl Heckman, living at 888 Adeline Drive in Elgin, Illinois. And I was born on December 1, 1918. The best record we have of what exactly happened in Ansel Keys' laboratory is in a box of taped interviews stored away in the archives of the Library of Congress. Each tape runs roughly two hours in length.

They contained the recollections of 18 of Ancel Keys' subjects who sat down in their 80s to leave a permanent record of their experience. My name is Sam Legg. I was born in Hackensack, New Jersey on November 10th, 1916. Max Campbellman with an M in the middle initial and November 7th, 1920. The interviews were conducted by two researchers from Johns Hopkins University, Richard Semba and Leah Calm.

The tapes were given to the library shortly thereafter, where they have sat on a shelf ever since, untouched. A forgotten record of 18 voices talking about an experience none of them will ever forget. It was known as the Minnesota Starvation Experiment. We were in Stadium South Tower. The football stadium underneath the stadium had quite a complex for research there. We lived in a dormitory there.

All the activities at the university were open to us. During their off hours, the men would roam the city. People living near the university saw them all the time. Young men in white shirts and khaki pants, taking long walks along the Mississippi, sitting in restaurants, drinking coffee, but never eating a thing. The men called themselves the guinea pigs. We were all in excellent physical health, and as far as

As far as they knew, we were all in good mental health at the time. We did not stay that way during the experiment, but we were. You can go to the Library of Congress and listen to the tapes in the reading room yourself if you like. You might end up wondering, what was Ancel Keys trying to accomplish by putting his subjects through so much? And was it worth it?

When I hear somebody say, oh, I'm simply starved, I know they don't know what they're saying. Because there's a real difference between what your body craves for as a result of starvation than what you normally feel as hunger. The second episode of this season of Revisionist History was devoted in large part to the story of the famous iodine experiments in Akron, Ohio during the First World War.

A doctor named David Marine was trying to figure out how to treat goiter, a condition that causes severe enlargement of the thyroid gland.

Goiter was widespread in the early part of the 20th century. Millions of people walked around with baseball-sized bulges on their necks. Marine wanted to see if regular doses of iodine could solve the problem. So he convinced the Akron school board to let him run a study on thousands of schoolgirls, feeding them regular doses of iodine to see if it prevented Goiter. Could that experiment, I wondered, be conducted today?

I called up the bioethicist Art Kaplan, who teaches at New York University. Today, to attempt this experiment to prevent goiter would be a hugely different experience for that researcher and for the subjects, the school board and their families. For one thing, when that experiment was done, there were no federal regulations. There was no federal oversight whatsoever.

of what was going on. These days, most experiments involving human subjects are closely regulated. They involve consent forms, disclosure statements, the right to drop out of a study at any given time. Kaplan's point was that compared to today, medical research in the past starts to look like the Wild West. If you could find the money and talk people into participating, off you went.

In Alabama, between the 1930s and the 1970s, the Public Health Service launched the Tuskegee Syphilis Study, where a group of African-American men were tricked into signing up for what they thought was medical treatment, when in fact all the researchers wanted to do was to find out what happened when you let untreated syphilis run its course. It was maybe the lowest moment in 20th century American medicine.

In the early 1960s, the Yale psychologist Stanley Milgram ran his infamous obedience study. 285 volts. Where Milgram deceived otherwise unsuspecting subjects into thinking that they were delivering high-voltage electric shocks to someone they'd never met. I absolutely refuse to answer anymore. Get me out of here. You can't hold me here. Get me out. Get me out of here. I'll tell you the next word is green, please.

In today's era, the number one consideration in any proposed experiment is its effect on the subject. Back then, the number one consideration was the value of what you could learn from the subject. The subject was thought of like a soldier in battle, someone whose well-being was secondary to the larger cause.

The answer to the vitamin question is not pills, but good food in plenty of variety, according to Dr. Keyes. If vitamins were missing from his food, a soldier might have to take concentrated vitamins. If he had vitamins but no food, he would still starve. The best way, naturally, is to supply vitamins in the food. Now remember the stature Ansel Keyes has attained during the Second World War. He's the world's greatest nutrition researcher,

He's closely involved with the war effort. He just developed the K-ration to great acclaim, and he looks around the world and he sees millions of people suffering from severe malnutrition. The war disrupted the food supply of entire continents. Millions of people were in concentration camps reduced to skeletons. Ancel Keys knew how little his field understood about prolonged malnutrition. What was the effect of long-term hunger on physical well-being, on psychological health?

And what was the best way to bring the undernourished back to health? What was more important? How much you fed someone or what you fed someone? So Keyes designs an experiment. He would need 36 subjects for at least a year. The first three months would be the control period. Each research subject would be stabilized at what Keyes estimated to be their correct weight.

Three full meals a day, intake matching outtake. Then, after stabilization, would come six months of severe calorie restriction, with the goal that each man lose 25% of his ideal weight. Exercise would be mandatory throughout the study. 22 miles a week of walking, up and down the Mississippi or through downtown Minneapolis, all through the long Minnesota winter and through the following summer.

Each participant tested on a regular basis. Blood samples, sperm samples, body fat, blood volumes. The men would be asked to keep journals and record their thoughts and dreams. And then, after six months of starvation, three months of recovery. The crucial part. Keys planned to test out different rehabilitation diets with varying amounts of calories, protein, and vitamins.

The experiment begins on November 19th, 1944. Keyes gathers his guinea pigs at the Laboratory of Physiological Hygiene underneath the football stadium. He stands in front of all 36 and gives them a speech he had stayed up the previous night practicing in front of his wife.

Quote, "We are here because of the problem of relief feeding in general and particularly in the war-devastated areas today." You can imagine the moment. Keyes, the brilliant scientist, bringing the group of young men before him under his spell. Human misery and want are qualities of life which properly bring an emotional response, but starvation is quantitative and must be met with quantitative answers.

Grand words, tailor-made for men of idealism, eager for a chance to serve their country. And then, are you ready to begin? And a deafening cheer goes up. When we started this experiment, we were all given the same amount of food. Listening to the oral histories from the veterans of the Minnesota Starvation Experiment is a strange experience. We had six slices of bread.

First they'd take away two slices, then four slices, six slices. And if you still didn't lose weight, then they'd start taking away your potato. The men are all at the end of their lives. Nearly 60 years have passed since the experiment ended. But rarely do any of them say, "I don't remember," or "I don't know." They know and they remember. And their memories are precise.

In fact, it seems like they've been reliving the long year between the fall of 1944 and the fall of 1945 ever since. Do you remember what your lowest weight got down to? 134, I believe. What was sort of your standard weight entering? 180. I went in at 220, and they standardized me down to 180 before...

The real experiment began. So I got down to 134. The 36 subjects started the experiment with high hopes. Keyes had arranged for them to take classes at the university. The men themselves organized dramatic productions and planned to hold educational seminars. Many wanted to prepare themselves for relief work after the war was over.

In the recruitment Leaflet Keyes sent out, he mentioned the intriguing possibilities in the fact that there was an all-women's dormitory nearby for those, as he put it, who wanted to be a guinea pig by day and a wolf by night. What happened after, once the semi-servations started? Things went downhill pretty fast. Well, not real fast. It didn't see much change at first. But when we got down to the...

to the place where we really knew what the word hunger meant. Instead of just saying, "I'm hungry, let's go eat." Which isn't the word hunger. I mean, it's a different word. When we really felt pains of hunger and we began thinking about food most of the time and so forth, we began to be more and more irritable.

After the three months of initial rigor, while they stabilized their weight, the severe calorie restrictions kicked in. Everyone now got just two meals a day. Cabbage, potatoes, bread slices, rutabagas, and occasional treats of macaroni and cheese. I was one of the few, no, I shouldn't say few, I was one of the many that mentally was transfixed on cookbooks.

and I collected probably 100 cookbooks. I would read cookbooks like you would read Reader's Digest. Some of the men would walk into Minneapolis, sit in restaurants, and watch other people eat, the way they might have once gone to a concert or watched a play. They dreamt about food. They argued about food. At mealtimes, they fixated on their plates. I mean, we would lick the plates. Really? And I remember... Well, I heard that caused a bit of tension.

I think it did. Particularly Eveling, for instance, one of the first that I saw doing that. And I thought, that's disgusting. Pretty soon I would do it myself. So, oh yeah, I mean, I just thought this is...

that you would actually degrade yourself to the extent of licking a plate. Give me a break. And then pretty soon we were all doing it. Coffee was one of the few indulgences they were allowed, so they drank it to excess. Twelve, eighteen cups a day. They chewed enormous amounts of bubble gum. They began souping their meals. Their word for adding water to everything they were given to create the sense that their portions were bigger.

One of the men took a date to see To Have and Have Not, starring Humphrey Bogart and Lauren Bacall. I'm sorry, Slim, but I still say you're awful good and I wouldn't take... Oh, I forgot. You wouldn't take anything from anybody, would you? That's right. One of the great romantic dramas of the war years. But he couldn't concentrate, except for the part where Bogart goes to a restaurant.

During a long starvation phase, Keyes began to lose some of his subjects. One of them went walking through downtown Minneapolis, and suddenly his resolve broke. He'd been having dreams of cannibalism. He went into 17 different soda fountains and gulped down a milkshake at each one. After that,

Finally, after six months of starvation, recovery.

On the final day, when you were able to finally break, do you remember what you did? Yes. They did a big breakfast for us, and most of us stuffed ourselves, and then I think I went downtown in one restaurant and went and ate another meal, and then got out and went to another one. And just, I mean...

One couldn't satisfy your craving for food by filling up your stomach. Many of us, I think, did unreasonable things. I was invited out for, I think, a Swiss steak dinner, and though I was filled to the brim, I went and stuffed a little bit more in on top and then got on a bus riding back to the stadium

and jostling up and down on the bus. All of a sudden I lost it all. Oh no. I got off at the next stop. So I felt sorry for the guy that was going to have to clean it up. But then I didn't stay around. In 1950, five years after the study ended, Keyes published The Biology of Human Starvation. His landmark two-volume account of what was learned during the study

To this day, that book helps doctors understand everything from famine relief to eating disorders. If you've ever used the terms metabolism, intermittent fasting, calories in and calories out, then you're talking about concepts that go back to the Keyes experiment. Ancel Keys did exactly what he set out to do. But his subjects? They were soldiers in a battle whose well-being was secondary to the larger cause.

Years later, the subjects of the starvation experiment gathered for a reunion. Ansel Keys, by then an old man, addressed the group. Someone asked him, did he think the benefits of what was learned were greater than the costs of what the men went through? He looked out at all the men in front of him and said, well, you're all here, aren't you? Out of all the interviews in the box of tapes at the Library of Congress, one stands out. The testimony of a man named Sam Legg.

His father was a stockbroker in New York City. Sam went to the elite St. Paul's private school in New Hampshire and then on to Yale. Sam Legg was someone the other guinea pigs looked up to. That is, until his behavior took a sharp turn during the six-month starvation period. His moods began to swing back and forth. Like many others, he got obsessed with cookbooks, but his obsession was pronounced. He took to eating in the corner by himself.

The historian Todd Tucker interviewed Legg for his book, The Great Starvation Experiment. He writes about the way Legg started to eat. He combined all the food on his tray into one pile. He then took his fork and stirred it and mashed it all together, the thimblefuls of fish chowder, spaghetti, peas, and potatoes, until it was a homogeneous dark gray-greenish paste on his plate. He then salted and peppered the amalgamation until it was crusted with seasoning.

When he had scraped every morsel off his plate, he then picked it up and licked it noisily until not a molecule of food remained. The slurping noise was so loud, it made the other men wince. In his oral history interview, Legg talks about how during the starvation phase, he felt his character start to slip away. I'll tell you a nasty moment. I was walking along, and I obviously had a buddy, but I don't know who it was. And, um...

It was deep into the semi-starvation and we were tired. When they crossed the street, they didn't have the energy to take the half step up onto the sidewalk. We were tired and weak. And so we were standing at a corner waiting for a light or something and a kid came along on a bicycle and he was really moving, pumping away and going, I said, I wonder where he's going? And then I said to myself, I know where he's going.

He's going home for supper, and I'm not. And then for a very brief, I hope it was brief, moment, I suddenly hated that boy. And that, I hate at this point to tell you this, because it doesn't speak very well for me. But I remembered it with, I guess, horror that I could feel such a thing. So utterly irrational. But there I was.

And you ask, an experience that I remember, I sure remember that. The interview is almost over. Just one final question. Is there anything that we haven't talked about or that I should have asked you or you'd like to add that seems relevant? You should have asked me why I'm missing fingers on my left hand. Okay. I keep saying to myself that this was because I was so weak emotionally

and I was chopping wood and I got the axe caught up in the tree and I didn't have a rapid enough reaction time to pull my hand away so I removed some fingers. He was at the house of two elderly ladies in Minneapolis who had befriended some of the subjects. Legg and his buddy would go and watch the women eat then go outside to split wood to steel themselves against the temptation to take any of the women's food.

I recognize that a human being can go through a period of mental illness. I think I was mentally ill. Was I mentally ill at the time that I removed the fingers? I don't know. I like to think that I wasn't. I like to think it was an accident. I'm not going to sit here and categorically say that I didn't do it on purpose. Legg was rushed to the hospital. Ancel Keys heard the news and came straight to his bedside.

Leg looked like a concentration camp survivor. His eyes had changed color, a strange side effect of deprivation that was common among the men. His corneas were a hard, brilliant white, the color of gleaming teeth. His skin was like flaky tree bark. His hand was a bloody mess. I'm quoting now from Tucker's account. "'Is there anything I can do for you, Sam?' asked Dr. Keyes. "'Yes,' said Sam." Keyes leaned closer to hear.

Keep me in the experiment, he said. Sam, I'm afraid I can't keep you in, said Keyes. You need rest and decent meals. The two of them went back and forth, and Legs said, Doctor, he said, his voice still hoarse and quiet. For the rest of my life, people are going to ask me what I did during the war. This experiment is my chance to give an honorable answer to that question."

And so, for the next five days, until Legg was released from the hospital, they brought him his meals from the laboratory kitchen in a cardboard take-out box. Because, of course, he couldn't eat the hospital food. That would be cheating. Could Ansel Keys do that experiment today? Not a chance. I asked the ethicist Art Kaplan about Keys' experiment. Kaplan knew the story well. He'd taught for years at the University of Minnesota.

Putting people on starvation diets, having them run around a city, Minneapolis, being confronted with food everywhere, having them stressed out, not a chance. The Minnesota starvation experiment, or any experiment like it, could never be repeated today. In the next episode of Revisionist History, we ask, are we sure that's a good thing? ♪

Revisionist History is produced by Eloise Linton, Lehman Gistu, and Jacob Smith, with Tali Emlin and Harrison Vijay Choy. Our editor is Julia Barton. Our executive producer is Mia Lobel. Original scoring by Louise Guerra, mastering by Flan Williams, and engineering by Nina Lawrence. Beth Johnson is our fact checker.

Special thanks to Todd Tucker. Go read his book, The Great Starvation Experiment, Ancel Keys and the Men Who Starve for Science. Special thanks also to Ariella Markowitz for production help on this episode. I'm Malcolm Glauba. If you target towns and cities, it's as clear as day that there will be civilian victims.

In 1945, the U.S. firebombed Tokyo, destroying a quarter of the city and killing more than 100,000 people. I wrote about this infamous bombing campaign in my audiobook, The Bomber Mafia. And one of the survivors' voices we hear is from a project called Paper City. Paper City is now out as a groundbreaking feature documentary. Director Adrian Francis explores what we choose to remember and hope to forget.

To find out more, visit papercityfilm.com and follow @PaperCityTokyo on social media.

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