Debug Information

Processing Details

• VTT File: swak428.vtt
• Processing Time: September 10, 2025 at 08:56 AM
• Total Chunks: 1
• Transcript Length: 79,075 characters
• Caption Count: 717 captions

Prompts Used

Prompt 1: Context Setup

You are an expert data extractor tasked with analyzing a podcast transcript. 
I will provide you with part 1 of 1 from a podcast transcript. 
I will then ask you to extract different types of information from this content in subsequent messages. Please confirm you have received and understood the transcript content.

Transcript section:
[00:00:00.240 --> 00:00:01.680] Looking for an easy escape?
[00:00:01.680 --> 00:00:06.800] Orange County, New York is just an hour from New York City and packed with unforgettable family fun.
[00:00:06.800 --> 00:00:14.640] Begin your adventure at picocny.com and build lasting memories at Legoland, New York, where Lego creations bring imagination to life.
[00:00:14.640 --> 00:00:18.480] Race go-karts and battle it out in LaserTag at the Castle Fun Center.
[00:00:18.480 --> 00:00:23.360] Or visit our charming farms to meet friendly animals, explore corn mazes, hayrides, and more.
[00:00:23.360 --> 00:00:27.200] With so much to discover, the only hard part is choosing where to begin.
[00:00:27.200 --> 00:00:30.400] Start planning now at picocny.com.
[00:00:37.440 --> 00:00:46.160] It is Thursday, the 21st of August, 2025, and you're listening to Skeptics with a K, the podcast for science, reason, and critical thinking.
[00:00:46.160 --> 00:00:58.160] Skeptics with a K is produced by Skeptic Media in association with the Merseyside Skeptic Society, a non-profit organization for the promotion of scientific skepticism on Merseyside, around the UK and internationally.
[00:00:58.160 --> 00:00:59.440] I'm your host, Mike Hall.
[00:00:59.440 --> 00:01:00.800] With me today is Marsh.
[00:01:00.800 --> 00:01:01.360] Hello.
[00:01:01.360 --> 00:01:02.160] And Alice.
[00:01:02.160 --> 00:01:02.720] Hello.
[00:01:03.040 --> 00:01:07.600] And this is the, I think this might be the longest we've gone in a while with just a regular lineup.
[00:01:07.760 --> 00:01:08.640] Sure, yeah, that's true.
[00:01:09.440 --> 00:01:12.480] We've not had a guest host on at all this year in 2025.
[00:01:12.720 --> 00:01:13.920] Now, zero of them.
[00:01:14.080 --> 00:01:16.480] The new world, you know, new order that we have.
[00:01:16.480 --> 00:01:17.120] But there we go.
[00:01:17.120 --> 00:01:18.720] It's not exciting times.
[00:01:18.720 --> 00:01:20.000] You know, we probably should.
[00:01:20.000 --> 00:01:21.520] Other people have got opinions.
[00:01:22.880 --> 00:01:24.400] And experience and expertise.
[00:01:24.400 --> 00:01:25.680] Yeah, do they matter?
[00:01:27.520 --> 00:01:31.120] So, listeners may remember that a few years ago, my granddad died.
[00:01:31.120 --> 00:01:33.040] During the last few years of his life, he had.
[00:01:35.760 --> 00:01:37.600] Jesus, that was a very cheery day.
[00:01:37.920 --> 00:01:39.040] He was a very old man.
[00:01:39.600 --> 00:01:42.240] People remember a few years ago, the Holocaust happened.
[00:01:42.800 --> 00:01:43.600] Wasn't that?
[00:01:43.920 --> 00:01:45.360] You might remember.
[00:01:45.680 --> 00:01:50.960] I'm just hoping to trick the listeners into thinking it's not as sad a story as it begins.
[00:01:51.200 --> 00:01:54.400] It's not as, I mean, we'll get to it.
[00:01:54.400 --> 00:02:00.000] During the last years of his life, he'd settled down with a woman called Pauline, who lived down in Cornwall.
[00:02:00.040 --> 00:02:05.880] So, my granddad had lived in France for decades, but eventually moved to Cornwall to live in the place that made his partner feel at home.
[00:02:05.880 --> 00:02:07.800] And Pauline was a really fascinating woman.
[00:02:07.800 --> 00:02:10.440] She was incredibly smart, but also incredibly well-read.
[00:02:10.440 --> 00:02:15.320] So the conversation could wander a million miles from where it started, always taking interesting twists and turns.
[00:02:15.320 --> 00:02:26.360] But she was also a woman with very severe anxiety and depression, for which, at the time of her death, almost a year to the day after my granddad passed, she was about to undergo electroconvulsive therapy to help treat.
[00:02:28.120 --> 00:02:30.840] This isn't a story about electroconvulsive therapy.
[00:02:30.840 --> 00:02:31.400] Okay.
[00:02:32.040 --> 00:02:34.680] Although maybe it is something we will cover in the future.
[00:02:34.680 --> 00:02:38.280] When Pauline died, she was experiencing symptoms of a heart attack.
[00:02:38.600 --> 00:02:45.800] And her friend, who was a nurse, was well aware that she was having symptoms of a heart attack and raised the medical alarms to get the medical support that she needed.
[00:02:45.800 --> 00:02:51.320] Unfortunately, the medical professionals didn't agree that she was having a heart attack and dismissed her symptoms as anxiety.
[00:02:52.040 --> 00:02:54.680] Ultimately, Pauline died a few days later.
[00:02:54.680 --> 00:02:59.800] And I don't know the medical ins and outs of her case, but I do know that her experience is not uncommon.
[00:02:59.800 --> 00:03:00.440] Yeah, yeah.
[00:03:00.440 --> 00:03:10.680] A study out of the University of Leeds published in 2016 looked at 564,412 patients with acute myocardial infarction, heart attack.
[00:03:10.680 --> 00:03:18.920] And Professor Gale, one of the study authors, said, This nationwide research shows that women are at a higher risk of being misdiagnosed following a heart attack than men.
[00:03:18.920 --> 00:03:27.560] When women with heart attack receive the wrong initial diagnosis, there are potentially important clinical repercussions, including an increased risk of death.
[00:03:27.880 --> 00:03:33.800] That's reassuring for me because I'm now worried that what I think is anxiety is actually a heart attack.
[00:03:33.800 --> 00:03:34.200] Okay.
[00:03:34.600 --> 00:03:37.240] But probably just anxiety.
[00:03:38.200 --> 00:03:44.960] And we will come back to symptoms so that you can be reassured that your symptoms are actually of anxiety.
[00:03:44.960 --> 00:03:45.440] Or maybe not.
[00:03:45.600 --> 00:03:46.080] Maybe you can.
[00:03:46.320 --> 00:03:47.040] Maybe I'm having a heart attack.
[00:03:47.120 --> 00:03:48.320] Maybe you're having a heart attack.
[00:03:48.320 --> 00:03:49.680] Just allow 15 years.
[00:03:50.000 --> 00:03:51.920] One constant slow heart attack.
[00:03:44.680 --> 00:03:52.080] Yeah.
[00:03:52.720 --> 00:04:03.040] So this research showed that women who had a final diagnosis of one particular type of myocardial infarction had a 59% greater chance of misdiagnosis compared with men.
[00:04:03.200 --> 00:04:03.520] Wow.
[00:04:03.520 --> 00:04:04.000] Okay.
[00:04:04.000 --> 00:04:12.960] And women who had a final diagnosis of the other type of myocardial infarction had a 41% greater chance of a misdiagnosis when compared with men.
[00:04:13.280 --> 00:04:16.880] And when it comes to myocardial infarction, early diagnosis is crucial.
[00:04:16.880 --> 00:04:28.400] So the same study found that in total, 168,534 or 29.9% of patients had an initial diagnosis which was not the same as their final diagnosis.
[00:04:28.400 --> 00:04:33.600] So in total, almost a third of patients were misdiagnosed in the first instance.
[00:04:33.600 --> 00:04:38.880] And they looked at two different types of myocardial infarction, and we are going to come to definitions later.
[00:04:38.880 --> 00:04:51.360] But they found that of those who were originally misdiagnosed but turned out to have one of the types of heart attack, the one-year mortality rate was more than double that of those who were diagnosed correctly in the first place.
[00:04:51.360 --> 00:04:53.920] So 25.5% compared to 10.7%.
[00:04:53.920 --> 00:04:57.760] So still reasonably good numbers, but a much bigger risk.
[00:04:57.760 --> 00:05:03.840] Other studies have also shown a disparity in diagnosis and treatment between men and women when it comes to heart attack symptoms.
[00:05:03.840 --> 00:05:16.080] So in 2022, a paper published in the Journal of the American Heart Association concluded that women and people of colour with chest pain waited longer to be seen by physicians independent of clinical features.
[00:05:16.080 --> 00:05:21.360] Women were independently less likely to be admitted when presenting with chest pain.
[00:05:21.360 --> 00:05:30.000] So they're less likely to go to the emergency department, but they're also less likely to be actually admitted once they've presented with chest pain.
[00:05:30.440 --> 00:05:38.040] This is based on a study looking at 101,372 emergency department visits over the course of four years.
[00:05:38.040 --> 00:05:47.400] Of those, they identified 4,152 emergency department visits, which were for adults aged 18 to 55 years with chest pain.
[00:05:47.400 --> 00:06:00.840] And because of their methodology, the statistical methodology, which is just statistical wizardry to me, they say that these visits represent 29 million emergency department visits in the probability matched national population.
[00:06:01.800 --> 00:06:06.200] Their study was looking both at disparities between genders and between race.
[00:06:06.200 --> 00:06:13.560] And we should be clear here that while I'm specifically talking about gender differences today, the disparity for people of colour is present and significant.
[00:06:13.560 --> 00:06:21.160] And I absolutely do not want to understate that people of colour are subjected to significant medical bias and it shows up everywhere.
[00:06:21.160 --> 00:06:22.440] It shows up here as well, of course.
[00:06:22.600 --> 00:06:23.880] Yeah, yeah, for sure.
[00:06:24.520 --> 00:06:25.720] So what's going on?
[00:06:25.720 --> 00:06:30.520] Why don't women get diagnosed properly when it comes to heart attack symptoms?
[00:06:30.600 --> 00:06:32.280] I'm asking you directly.
[00:06:32.680 --> 00:06:34.760] Their pain is disbelieved.
[00:06:34.760 --> 00:06:36.280] That's definitely part of it.
[00:06:36.280 --> 00:06:36.840] Sure.
[00:06:36.840 --> 00:06:45.080] I would imagine it's because the model symptom picture is based on the symptoms as they present in men.
[00:06:45.080 --> 00:06:46.360] And so women have different symptoms.
[00:06:46.680 --> 00:06:50.040] And so women would have a different symptom picture, which doesn't match the men's symptom picture.
[00:06:50.040 --> 00:06:51.640] So well, it's not a heart attack then.
[00:06:51.640 --> 00:06:58.040] Which would be because a lot of clinical research will be done just on men to exclude gender as a variable.
[00:06:58.040 --> 00:06:58.840] Yes.
[00:06:58.840 --> 00:07:06.600] And you'd think that, wouldn't you, from all the talk that gets shared around feminist spaces, that is what we are led to believe is the cause for that disparity.
[00:07:06.840 --> 00:07:07.960] That's my understanding.
[00:07:07.960 --> 00:07:09.680] Yeah, so I don't know.
[00:07:09.760 --> 00:07:16.160] I'm surprised, I'd be surprised by that, because I'd be surprised if the symptoms of heart attack in women were particularly different from men.
[00:07:17.520 --> 00:07:19.920] Therein is my piece for today.
[00:07:14.760 --> 00:07:20.080] Okay.
[00:07:20.640 --> 00:07:24.240] So this has been a piece that I've been meaning to write for ages.
[00:07:24.240 --> 00:07:29.920] And the reason I finally got around to it was because I was listening to a feminist podcast that usually does pretty well at being skeptical.
[00:07:29.920 --> 00:07:31.040] And I heard this misconception.
[00:07:31.040 --> 00:07:36.480] And I hear this a lot from people in feminist spaces and in skeptical spaces that, you know, women just have different heart attack symptoms.
[00:07:36.480 --> 00:07:39.680] The reason we don't diagnose women is because women have different heart attack symptoms.
[00:07:40.080 --> 00:07:40.560] Why would they?
[00:07:40.800 --> 00:07:47.440] The problem is laid out that broadly speaking, where women have heart attacks, their symptoms are atypical compared to the symptoms that men have.
[00:07:47.440 --> 00:07:50.320] So the cause of misdiagnosis, therefore, is simple.
[00:07:50.320 --> 00:07:56.400] We do all our medical research in men and we do all our medical education on the experience of men, particularly white men, of course.
[00:07:56.400 --> 00:07:58.640] And so we miss what's happening.
[00:07:58.640 --> 00:08:02.160] We miss the picture in women because women are different and weird in some way.
[00:08:02.160 --> 00:08:06.320] I don't understand how that would possibly be true because the heart isn't that mysterious.
[00:08:07.040 --> 00:08:18.640] I could imagine it would be if there was something that was, you know, one of your glands that produces different types of hormones, and the way that hormone would play out in the body is going to be different for women than men because of the way that the mix of hormones in a woman than a man.
[00:08:18.640 --> 00:08:21.520] But a heart is just a pump that sends blood around the body.
[00:08:21.680 --> 00:08:26.960] And blood is the same, and the body, like I said, the circulatory system isn't massively different.
[00:08:26.960 --> 00:08:28.880] So some of it comes from the idea.
[00:08:28.880 --> 00:08:32.000] So we do know that heart attacks are less common in women than men.
[00:08:32.000 --> 00:08:35.440] They're still really, really fucking common in women, but they're less common in women than men.
[00:08:35.440 --> 00:08:39.440] And then people start to run away with the bias and the ideas behind that.
[00:08:39.520 --> 00:08:41.760] Also, women have got pink hearts, right?
[00:08:41.760 --> 00:08:42.000] Right.
[00:08:42.480 --> 00:08:43.440] Men's hearts are blue.
[00:08:43.440 --> 00:08:44.400] Little pink hearts.
[00:08:44.560 --> 00:08:47.200] Women's hearts are like the heart shape.
[00:08:47.280 --> 00:08:48.080] The classic heart shape.
[00:08:48.240 --> 00:08:49.040] The classic heart shape.
[00:08:50.640 --> 00:08:50.800] Yeah.
[00:08:49.480 --> 00:08:53.120] Men's ones that have that kind of more masculine, aggressive kind of shape of a heart.
[00:08:53.280 --> 00:08:56.240] Cinched in the middle, like every female Disney character.
[00:08:57.520 --> 00:09:02.360] And of course, when it comes to some of this, it's exactly your point.
[00:08:59.840 --> 00:09:06.920] Women are disbelieved when they report pain because pain is subjective.
[00:09:07.080 --> 00:09:09.080] Reporting your experience of pain is subjective.
[00:09:09.080 --> 00:09:17.000] Never mind that hearing and writing down a report of pain is also subjective, which we will come to.
[00:09:17.000 --> 00:09:26.680] But definitely this idea that, oh, well, you know, women are misreporting their symptoms and therefore, you know, they're getting dismissed about some experiences.
[00:09:27.000 --> 00:09:32.040] Either dismissed or attributed to something else because, well, women's bodies are weird in it.
[00:09:32.040 --> 00:09:35.320] So if you have got this symptom, it's probably your hormones.
[00:09:35.320 --> 00:09:36.600] It's probably your time of the month.
[00:09:36.600 --> 00:09:38.360] It's probably this, it's probably that.
[00:09:38.360 --> 00:09:43.720] And before you know it, you've kind of you've gone through so many things that you've delayed treatment for a heart attack.
[00:09:43.720 --> 00:09:53.880] And actually, I have a side rant, which is related because I don't think this is as uncommon a thought pattern when it comes to trying to understand and improve the issues with gender bias and other biases as well.
[00:09:53.880 --> 00:09:55.720] You'll have noticed this in the workplace.
[00:09:55.720 --> 00:10:09.960] If you engage with any women in the workplace type initiatives looking at addressing bias, you might see a leadership course that's directed at women in particular or some training on how to ask for a promotion directed at women in particular.
[00:10:09.960 --> 00:10:17.320] As if the reason that women aren't in leadership positions is because they aren't very good leaders and they need teaching how to be trained not to ask properly.
[00:10:18.200 --> 00:10:19.240] They've never learned how to ask.
[00:10:19.320 --> 00:10:22.280] Or the reason they don't get promotions is because they're too timid to ask.
[00:10:23.080 --> 00:10:26.520] I am too timid to ask and I don't get promotions and pay arises as a result of that.
[00:10:26.680 --> 00:10:28.600] You're getting ahead of my point here, right?
[00:10:28.600 --> 00:10:32.920] Because I think when you lay it out like that, it becomes clear that it's bioessentialism at play.
[00:10:33.240 --> 00:10:37.080] Or if we're being really charitable, it's about how women are perceived to be socialized.
[00:10:37.080 --> 00:10:50.800] But ultimately, and this happens for people of colour and women of colour in particular, what we're saying is the reason people are not present in leadership is because there's some fundamental flaw in who they are, and we need to do something to change them, something about who they are.
[00:10:50.800 --> 00:10:52.320] But that's not the issue at all, right?
[00:10:52.320 --> 00:11:01.120] Women aren't worse leaders than men, just people are biased to either not take leadership from women, to not see women as leaders, or to not recognize the wide variety of leadership styles.
[00:11:01.120 --> 00:11:06.560] But similarly, okay, maybe fewer women do ask for promotions than men, but that isn't unique to women.
[00:11:06.560 --> 00:11:10.640] It can also be the case for people new to a certain type of workplace.
[00:11:10.640 --> 00:11:25.360] If you're from a socioeconomic group that doesn't have access to job promotions in the same way as your current workplace, or you're from a particular culture, or you're a first or second generation immigrant, you might not have access to the language or social etiquette rules for asking for promotions.
[00:11:25.360 --> 00:11:27.040] And that's exactly it for you, Marsh, right?
[00:11:27.040 --> 00:11:33.920] That you've grown up in a particular environment that makes you more concerned about the precarity of work.
[00:11:33.920 --> 00:11:34.960] Yeah, I guess so.
[00:11:35.520 --> 00:11:36.880] By which you mean Bishop Auckland.
[00:11:38.800 --> 00:11:45.040] I don't think in the entirety of my parents, but either of my parents' working career, they would have ever asked for a pay rise.
[00:11:45.360 --> 00:11:53.280] I don't think, because I think groups, in certain types of jobs, because I'm not working those jobs, and I have asked for a pay rise.
[00:11:53.280 --> 00:11:57.840] I've just, I find it a much harder thing to do than other people who are like, this is what I deserve.
[00:11:57.840 --> 00:12:07.040] You've never had that modeled to you in the same way as somebody who has had a parent who's worked in a job where asking promotions is part and parcel of working in that field.
[00:12:07.040 --> 00:12:10.720] Yeah, I also don't change jobs anywhere near as often as a lot of other people do.
[00:12:10.720 --> 00:12:18.400] I've worked two jobs basically in my adult life, and even those overlapped for a period of like eight years or ten years.
[00:12:18.400 --> 00:12:20.240] I've never asked for a pay rise either.
[00:12:20.320 --> 00:12:21.840] Never in my life have I asked for a pay rise.
[00:12:22.080 --> 00:12:23.840] Move between jobs and that can normally come like that way.
[00:12:23.920 --> 00:12:25.360] That comes with a bit of a pay bump.
[00:12:25.680 --> 00:12:35.880] It does occasionally, you know, it does come along with a pay bump typically, not always, but it's something I find very challenging to do because I think if I go in and say, I'm worth this, they'll go, no, you're not, you're fine.
[00:12:35.880 --> 00:12:36.680] Yeah, yeah, yeah, I have to do that.
[00:12:36.840 --> 00:12:38.840] And so, and so, okay, well, I just want to answer it.
[00:12:39.400 --> 00:12:40.680] I constantly have the mentality.
[00:12:40.680 --> 00:12:44.120] I've actually been coming up in kind of conversation about having it lately.
[00:12:44.120 --> 00:12:51.320] I constantly have the mentality of if your boss needs to talk to you about something, it's because you're in trouble, it's because something's going to go wrong for any fucking time.
[00:12:52.040 --> 00:12:54.920] A few weeks ago, my boss said to me, Can I have a word with you later?
[00:12:55.560 --> 00:12:56.840] And that was it.
[00:12:57.080 --> 00:13:01.800] I had it with Simon, who I work for, three weeks ago, four weeks ago.
[00:13:01.800 --> 00:13:05.960] He said, Oh, we're getting to a point in the math work that we do where it's quiet over summer.
[00:13:05.960 --> 00:13:08.120] So let's have a chat about your other work.
[00:13:08.520 --> 00:13:10.520] August 18th, is that all right?
[00:13:11.400 --> 00:13:14.360] No, I'm just not going to sleep for a month, actually.
[00:13:14.680 --> 00:13:16.120] That's exactly how I would respond.
[00:13:16.280 --> 00:13:16.680] It's fine.
[00:13:16.840 --> 00:13:17.560] It's just fine.
[00:13:17.560 --> 00:13:18.200] Yeah.
[00:13:18.520 --> 00:13:25.080] On my list of things to write about is why I think imposter syndrome is a myth.
[00:13:25.080 --> 00:13:28.280] Because I think this plays into this same conversation.
[00:13:28.280 --> 00:13:44.840] The idea is that the people who are struggling in particular workplaces are at fault for finding those workplaces difficult rather than the bias and systems in processes in place in those workplaces being the issue that aren't really properly accessible for certain groups of people.
[00:13:44.840 --> 00:13:48.600] And that's why certain groups of people are more vulnerable to feeling like imposters in those places.
[00:13:48.600 --> 00:13:52.680] That's true, although I don't fit into any of those groups of people that you're talking about.
[00:13:52.680 --> 00:13:55.240] I have no marginalization going on.
[00:13:55.240 --> 00:13:58.600] I don't even like, Mike can at least claim neurodivergence against the killer.
[00:13:58.920 --> 00:14:00.200] I don't even have that excuse.
[00:14:00.200 --> 00:14:01.720] I was fucking thrilled when I got that one.
[00:14:01.800 --> 00:14:02.840] He's like, yes.
[00:14:04.520 --> 00:14:05.640] I just am an imposter.
[00:14:05.640 --> 00:14:08.760] That's the only remaining explanation.
[00:14:09.400 --> 00:14:12.320] There's a whole separate conversation about being a jack of all trades.
[00:14:12.200 --> 00:14:17.520] The issue isn't that women don't know how to ask for a promotion.
[00:14:18.080 --> 00:14:24.800] The issue is that the system is set up so that certain types of people are rewarded over others and we only give promotions to people who ask for them.
[00:14:25.440 --> 00:14:27.280] Why is that the way that it is?
[00:14:27.280 --> 00:14:30.320] We don't have to only give promotions to people that ask for them.
[00:14:30.320 --> 00:14:41.200] We could, you know, use personal development reviews to give promotions to people who have made improvements or give, you know, actually be seeking that out for them and not expecting people to ask.
[00:14:41.200 --> 00:14:48.160] Yeah, and obviously the way systems of work are set up in most workplaces is they will pay you what they think they can get away with paying you.
[00:14:48.240 --> 00:14:48.320] Yeah.
[00:14:49.520 --> 00:14:55.360] So the people who go in there say, I am worth this, are more likely to get that than the people who say, well, I'll accept the thing that you think I'm worth.
[00:14:55.360 --> 00:14:58.960] And of course, yeah, the issue is capitalism, but the issue is also biased.
[00:15:00.080 --> 00:15:11.200] And when we're trying to solve it, we're saying, okay, so the problem is this, the reason these groups of people aren't getting access to things in the workplace is because of a flaw with them, not a flaw with the system.
[00:15:11.200 --> 00:15:21.680] So I will go, I've attended women's event groups targeted at supporting women in the workplace that have initiated a conversation with let's teach women how to ask for promotions.
[00:15:21.680 --> 00:15:24.080] It's like, do I have to do yet more learning?
[00:15:24.080 --> 00:15:25.840] Like, I've done women leadership training.
[00:15:25.840 --> 00:15:30.000] Like, fucking men leaders do not have to do leadership training.
[00:15:30.000 --> 00:15:32.480] And half of them are fucking terrible at it.
[00:15:32.480 --> 00:15:36.720] But I have to do leadership training just to prove that I can be a woman and a leader.
[00:15:36.960 --> 00:15:38.000] It's ridiculous.
[00:15:38.000 --> 00:15:40.480] And your leadership training course was called Girl Boss.
[00:15:42.720 --> 00:15:46.960] And this is compounded even further for people of colour, and particularly women of colour.
[00:15:46.960 --> 00:15:54.240] There's loads of specific training for women of colour in the workplace to make them more palatable for the white workplace.
[00:15:54.240 --> 00:15:55.920] It's ridiculous.
[00:15:56.240 --> 00:16:03.160] And I think this is what's kind of at play when it comes to the medical bias here: okay, the flaw is with the women.
[00:15:59.840 --> 00:16:06.120] The reason women are getting misdiagnosed is because of something that's wrong with them.
[00:16:06.280 --> 00:16:09.160] They're atypical somehow, and that's it's their fault.
[00:16:09.160 --> 00:16:11.720] And that is just a fundamental flaw in how we think of things.
[00:16:11.720 --> 00:16:15.960] Yeah, you just haven't learned to ask the doctor for you to not be having a heart attack right now.
[00:16:16.600 --> 00:16:32.600] So, while it is true that medical research is biased towards men or in favor of men, and we sometimes make assumptions based on the experience of entire populations, based on the experiences of just a privileged few, it is not the case that men and women have vastly different symptoms when it comes to heart attacks.
[00:16:32.600 --> 00:16:35.640] So, this is the crux of what I want to talk about today.
[00:16:37.320 --> 00:16:39.080] So, you set us up with a trick question.
[00:16:39.080 --> 00:16:41.080] Is that why do they have different symptoms?
[00:16:41.080 --> 00:16:51.880] But the reason I wanted to set you up with that question was because I think it's one of those things where we've started talking about bias and the issues of bias in the medical world.
[00:16:51.880 --> 00:16:55.320] And same with women talking about workplace initiatives.
[00:16:55.320 --> 00:16:58.680] It's trying to address the problem and identify what the problem is.
[00:16:58.680 --> 00:17:04.360] And so, we come to a conclusion and we get to that conclusion and assume that's the answer.
[00:17:04.360 --> 00:17:10.280] And so, there are lots of skeptics who believe that the reason is that women have different symptoms compared to men.
[00:17:10.280 --> 00:17:11.640] And okay, well, that's just the answer now.
[00:17:11.640 --> 00:17:12.920] So, now we need to address that.
[00:17:13.480 --> 00:17:18.040] There will be listeners listening to this who be like, That's what I always thought, that women have different symptoms.
[00:17:18.040 --> 00:17:29.480] I'm enlightened enough to know that women are treated differently to men, but I've got the furthest I've got is they have different symptoms and not actually applied our critical thinking to that position.
[00:17:29.480 --> 00:17:37.960] And as skeptics, we should be applying critical thinking to all of our positions, even if we think we get to the answer that challenges that bias and then just stop there.
[00:17:37.960 --> 00:17:39.400] That's that's not helpful, right?
[00:17:39.400 --> 00:17:41.400] Yeah, I've been fully add off by that.
[00:17:41.640 --> 00:17:45.360] You are mugged right off, my fucking mugged right off by the position by that.
[00:17:46.960 --> 00:17:50.560] To 20,000 listeners as well, I sound on the right brick now, don't I?
[00:17:50.880 --> 00:17:55.280] But that's the point: is that there will be, and I believed it myself a few years ago.
[00:17:55.280 --> 00:18:02.160] Like, it's a really seductive answer because, well, all of medical research is done in men, we know that.
[00:18:02.160 --> 00:18:09.040] We don't think about the women's experience, and so that's an obvious justification.
[00:18:09.040 --> 00:18:12.640] But actually, have we applied our critical thinking to that position?
[00:18:12.640 --> 00:18:15.840] And, like you say, the heart is the heart.
[00:18:15.840 --> 00:18:17.600] That's only so different it can be.
[00:18:17.760 --> 00:18:22.560] It doesn't matter how obvious an answer it is if the evidence doesn't stack up behind it, right?
[00:18:22.880 --> 00:18:24.240] So, what is the science?
[00:18:24.240 --> 00:18:26.960] So, firstly, we need to understand what a heart attack is.
[00:18:26.960 --> 00:18:29.040] I've been using, I've been throwing a lot of words around.
[00:18:29.040 --> 00:18:32.960] A heart attack medically is known as a myocardial infarction or MI.
[00:18:32.960 --> 00:18:34.240] It's a very specific thing.
[00:18:34.240 --> 00:18:41.360] Well, actually, two very specific things: there's a STEMI or ST elevation myocardial infarction or an N-STEMI.
[00:18:41.760 --> 00:18:47.920] I don't know how medics actually colloquialize that, whether they spell it out every time or not.
[00:18:47.920 --> 00:18:53.360] But I'm going with STEMI and non-STEMI, or non-ST elevation myocardial infarction.
[00:18:53.360 --> 00:19:15.040] So, according to the fourth universal definition of myocardial infarction from 2018, fourth because they renew it every now and then to make sure that it's up to date, the clinical definition of MI denotes the presence of acute myocardial injury detected by abnormal cardiac biomarkers in the setting of evidence of acute myocardial ischemia.
[00:19:15.040 --> 00:19:25.520] So, essentially, the blood flow to the heart has been blocked or restricted somehow, and therefore the heart tissue has become damaged, leading to particular markers to be elevated in the blood.
[00:19:25.520 --> 00:19:35.080] That's distinct from an art attack, which is where Neil Buchanan rocks up at your school and paints a giant mural on the floor in the playground, but makes you watch it from the sky.
[00:19:35.080 --> 00:19:37.560] He makes you watch it from the sky, and they didn't even have drones back there.
[00:19:37.720 --> 00:19:38.440] He didn't.
[00:19:38.440 --> 00:19:42.520] And he leaves paint on the playground, and then that's the playground damage now.
[00:19:42.520 --> 00:19:55.960] Oh no, so the causes can vary, but it's not unusual for the cause to be arthrosclerosis of a blood vessel, which may involve a plaque rupture that causes a blood clot to form and block an artery.
[00:19:55.960 --> 00:19:59.080] But it can be other causes as well.
[00:19:59.400 --> 00:20:06.680] And the symptoms of a heart attack include pain or discomfort in the chest, which arrives reasonably suddenly and lasts for more than 15 minutes.
[00:20:06.680 --> 00:20:11.880] It might feel more like pressure, tightness, or squeezing than pain specifically.
[00:20:12.200 --> 00:20:25.480] You might experience pain which radiates down your arms, particularly the left arm, but it can be both, or pain that travels into your neck, jaw, back, or stomach, or feeling sick, sweaty, light-headed, or short of breath.
[00:20:25.480 --> 00:20:34.920] There is a reason I asked you that question a few weeks ago when you had jaw pain and some other, like left, you were feeling really unwell and you had jaw pain.
[00:20:34.920 --> 00:20:37.880] I was like, Do you also feel sick and short of breath?
[00:20:37.880 --> 00:20:39.160] Yeah, you thought I was having a heart attack.
[00:20:39.160 --> 00:20:39.800] You might have been having an artist.
[00:20:39.880 --> 00:20:41.000] You were having a heart attack.
[00:20:42.120 --> 00:20:42.680] You weren't.
[00:20:42.680 --> 00:20:43.880] I wasn't having a heart attack.
[00:20:43.880 --> 00:20:44.360] Unbelievable.
[00:20:44.600 --> 00:20:47.080] Sudden jaw pain is a reasonably classic.
[00:20:47.480 --> 00:20:48.520] I've just been clenching my jaw.
[00:20:48.520 --> 00:20:49.240] I was stressed.
[00:20:49.240 --> 00:20:49.560] Well, yes.
[00:20:49.800 --> 00:20:50.520] We've had a lot of dress.
[00:20:52.440 --> 00:21:01.160] Is when you have teeth, and I get a lot of jaw pain because I clench my teeth, but that is a common symptom of heart attack, especially if it arrives really suddenly.
[00:21:01.160 --> 00:21:03.160] Especially if you're stressed about having a heart attack.
[00:21:03.160 --> 00:21:08.840] But also, yeah, it's why it can get dismissed as anxiety because, yeah, you suddenly feel sick and short of breath and jaw pain.
[00:21:08.840 --> 00:21:11.560] It's like, okay, well, that could literally be a panic attack.
[00:21:12.520 --> 00:21:19.840] So, if you present with symptoms of a heart attack, the first thing you need is an urgent ECG, which can detect changes in how your heart is beating.
[00:21:19.840 --> 00:21:27.920] And you might also have bloods taken to detect if you have elevated biomarkers, particularly cardiac troponin.
[00:21:28.560 --> 00:21:41.840] A study published in 2019 looking at patient reporter symptoms in 1,941 patients showed that women were more likely to have typical heart attack symptoms than men, 77% compared to 59%.
[00:21:42.160 --> 00:21:45.680] More likely to have typical, as in textbook.
[00:21:45.920 --> 00:21:51.120] Textbook, typical classical symptoms of a heart attack are more common in women than in men.
[00:21:51.120 --> 00:21:54.640] So I'm going to decide that that's because men have exactly the same symptoms.
[00:21:54.640 --> 00:21:59.840] They're just very bad at reporting them because men have to be stoic and not mention anything.
[00:21:59.840 --> 00:22:02.000] But men aren't stoic and just go, no, I'm fine.
[00:22:02.000 --> 00:22:02.640] No, I'm fine.
[00:22:02.640 --> 00:22:03.280] I can put up with it.
[00:22:03.280 --> 00:22:03.600] It's fine.
[00:22:03.600 --> 00:22:04.240] Feed the bands.
[00:22:04.240 --> 00:22:04.720] Force myself.
[00:22:05.040 --> 00:22:12.240] So that might be relevant, but men present at the emergency department with heart attack symptoms more often than women do.
[00:22:12.240 --> 00:22:13.120] Okay, that's interesting.
[00:22:13.120 --> 00:22:22.320] So women are more likely to avoid going to the doctors with heart attack symptoms, but when they do, they're more likely to have your typical heart attack symptoms than men.
[00:22:22.320 --> 00:22:23.840] And to be clear, I was taking the piss.
[00:22:23.840 --> 00:22:24.080] Yeah.
[00:22:25.600 --> 00:22:26.880] I know you two will know this.
[00:22:26.880 --> 00:22:27.760] The listeners might not.
[00:22:27.760 --> 00:22:30.160] They might think, ah, fuck it, but he just looks for fucking bias everywhere.
[00:22:30.160 --> 00:22:32.640] He doesn't have placebo's gone to his fucking head.
[00:22:33.280 --> 00:22:43.440] Furthermore, typical heart attack symptoms in women have greater predictive value for myocardial infarction in women than men.
[00:22:43.440 --> 00:22:55.920] So actually, when women present with three or more typical clinical features of myocardial infarction, the likelihood that they're actually having a heart attack is higher compared to men.
[00:22:56.560 --> 00:23:02.280] And this is not the only study to disagree with the assumption that women have atypical symptom presentation.
[00:23:02.280 --> 00:23:14.200] There are some studies which suggest that women might be more likely to present with heart attack symptoms that don't include chest pain, but that doesn't mean that they're not experiencing classical heart attack symptoms.
[00:23:14.200 --> 00:23:20.360] And it might mean that their descriptions of pain differ rather than being a different physiological experience.
[00:23:20.360 --> 00:23:30.120] So women are more likely to report that their bra is too tight, that they've got a tension under the bra strap area, and it just feels like their bra is too tight.
[00:23:30.360 --> 00:23:32.040] And that's what's causing the discomfort.
[00:23:32.040 --> 00:23:34.760] I mean, women are more likely to report that than men.
[00:23:34.760 --> 00:23:35.160] Yes.
[00:23:35.960 --> 00:23:39.000] Just statistically, I think almost 100% more likely.
[00:23:39.000 --> 00:23:40.600] Not quite, but almost 100% more likely.
[00:23:40.760 --> 00:23:42.840] Well, men famously go out and get the bra properly fitted.
[00:23:43.160 --> 00:23:45.480] Exactly, that's why improperly fitted.
[00:23:46.120 --> 00:24:02.280] So there might be a reason why a woman might misattribute the cause of that pain, but it might also be that a woman might be more likely to describe the kind of tightness or pulling tension pain or discomfort and not quite classify it as pain.
[00:24:02.280 --> 00:24:04.680] You might argue that women have a higher pain threshold than men.
[00:24:04.680 --> 00:24:09.480] They might not get to the point of calling it pain at the same point that men might call it pain.
[00:24:09.480 --> 00:24:11.720] I'm going to get emails about saying that.
[00:24:11.720 --> 00:24:17.960] Yeah, I bet that's also just a reporting bias because it's impossible to, it's harder to really tell what the pain threshold is.
[00:24:17.960 --> 00:24:20.440] Actually, I'm going to start.
[00:24:20.760 --> 00:24:25.240] Speaking of which, we got so many emails from people commenting on our layotrill.
[00:24:25.400 --> 00:24:25.560] Yeah.
[00:24:26.360 --> 00:24:31.320] I think we said a cyanide instead of arsenic and arsenic instead of cyanide, making the same fucking mistake again.
[00:24:31.480 --> 00:24:32.360] I mean, it doesn't matter.
[00:24:32.360 --> 00:24:33.320] It was a throwaway comment.
[00:24:33.640 --> 00:24:36.280] We know if we were making a point, we'd have looked it up.
[00:24:36.280 --> 00:24:37.720] But God, we got so many.
[00:24:37.880 --> 00:24:38.840] I mean, thank you.
[00:24:38.840 --> 00:24:41.080] We do like to be corrected on things when we get it wrong.
[00:24:41.080 --> 00:24:44.200] It's useful, but it was a pure slip of the tongue.
[00:24:45.360 --> 00:24:47.120] Because none of us had that in our notes, right?
[00:24:47.120 --> 00:24:52.640] That was just an off-the-cuff comment in the middle of the show, and we kind of remember the fact.
[00:24:52.640 --> 00:24:53.840] Don't listen to us, listeners.
[00:24:54.240 --> 00:24:55.120] Well, I mean, listen to Alice.
[00:24:55.760 --> 00:24:57.040] Listen to Alice, she's got notes.
[00:24:57.040 --> 00:25:04.000] Listen to the stuff we've obviously written, but take some of the off-hand stuff with a slight pinch of salt.
[00:25:04.000 --> 00:25:15.280] But the study I mentioned before found that actually 93% of women presented with chest pain, they were just also more likely to report a range of the other symptoms associated with a heart attack.
[00:25:15.280 --> 00:25:28.960] So the authors argued the presence of these additional symptoms in women may cloud their symptom presentation, influence clinician interpretation of symptoms, and provide the basis for the atypical symptom message to gain dominance.
[00:25:29.600 --> 00:25:31.600] And this comes to your point about pain, Marsh.
[00:25:31.680 --> 00:25:37.120] We know from all sorts of different studies that women in pain are less likely to be believed about their pain.
[00:25:37.120 --> 00:25:51.600] So if a woman goes to a medical professional and says, I've got a pain in my chest and nausea and palpitations and pain in my jaw, the doctor might respond, okay, nausea and palpitations and jaw pain could be anxiety, completely glossing over the report of chest pain.
[00:25:51.600 --> 00:26:07.040] And when a patient is later diagnosed with a myocardial infarction, her medical notes might not make any mention of the chest pain that she reported to her doctor because they didn't write it down because they were listening for symptoms of anxiety.
[00:26:07.360 --> 00:26:20.480] According to a report from the British Heart Foundation on gender bias in heart attack care, a woman in the UK is 50% more likely than a man to receive an initial wrong diagnosis following a heart attack, according to a study carried out between 2002 and 2013.
[00:26:20.800 --> 00:26:24.160] But there's more to it than just medical bias, too.
[00:26:24.480 --> 00:26:39.640] So, those studies I've mentioned a couple of times showed that women who turn up at the emergency department with symptoms of myocardial infarction experience a delay in being triaged and seeing a medical professional, a delay in medical testing, and a delay in diagnosis.
[00:26:39.640 --> 00:26:45.000] Studies also see a delay in women presenting at the emergency department in the first place.
[00:26:45.320 --> 00:26:51.400] So, one of the issues that the British Heart Foundation raises is an awareness one, both for patients and their doctors.
[00:26:51.400 --> 00:27:01.960] According to them, in the UK, women have roughly half the number of heart attacks as men, but globally, coronary heart disease, the main cause of heart attacks, is still the biggest killer in women.
[00:27:01.960 --> 00:27:05.720] And in the UK, it kills more than twice as many women as breast cancer.
[00:27:05.720 --> 00:27:12.680] Because really common diseases that are less common in one gender than another are still really common in the gender that are less affected because maths.
[00:27:12.680 --> 00:27:18.120] Although, that sounds a very scary statistic, but obviously, part of that is breast cancer doesn't kill that many women.
[00:27:18.200 --> 00:27:22.360] Exactly, breast cancer is normally as legal as it used to be because of the advances of treatment.
[00:27:22.360 --> 00:27:22.760] Yeah.
[00:27:22.760 --> 00:27:27.080] But if you asked me, I'd have said breast cancer kills more women than heart attacks do.
[00:27:27.240 --> 00:27:29.720] Just on, just on off the cough, what do you reckon?
[00:27:29.720 --> 00:27:31.960] Back of the envelope, finger in the air, yada, yada, yada.
[00:27:32.040 --> 00:27:34.120] I'd have said, well, I don't want to imagine breast cancer.
[00:27:34.280 --> 00:27:36.840] I think that's a hyper-awareness issue in the future.
[00:27:37.000 --> 00:27:38.520] I think you're probably the general population.
[00:27:38.520 --> 00:27:42.360] I think you're probably, very aware of breast cancer and way less aware of heart disease.
[00:27:42.680 --> 00:27:47.160] But also, people make the assumption that heart disease affects men more than women.
[00:27:47.160 --> 00:27:51.640] And it does, to some extent, affect men more than women, but it still affects a lot of women.
[00:27:51.640 --> 00:27:55.880] And this comes back to the idea that knowledge and education is based on the experiences of men.
[00:27:55.880 --> 00:28:08.520] Heart disease and heart attacks are often considered to be a man's disease, which means women might be less likely to consider if their symptoms are related to a myocardial infarction and therefore less likely to make their way to the emergency room.
[00:28:08.520 --> 00:28:22.080] Once they see a medical professional, a lack of awareness of the risk factors for women experiencing myocardial infarction can mean the diagnosis isn't on the doctor's radar as an option for that patient and might then delay diagnosis from the doctor.
[00:28:22.400 --> 00:28:26.720] And in fact, some risk factors might even have a greater impact in women than men.
[00:28:26.720 --> 00:28:33.360] One study showed that smoking, diabetes, and high blood pressure have a greater chance of leading to a heart attack in women.
[00:28:33.360 --> 00:28:38.880] They're just maybe less likely to have to smoke and less likely to have high blood pressure.
[00:28:39.520 --> 00:28:50.320] And another reported gender difference is that while women do have similar increases in circulating cardiac troponin when experiencing myocardial infarction, they start with a lower baseline.
[00:28:50.320 --> 00:28:54.960] So that increase can be easier to miss when the thresholds are set against the baseline measured in men.
[00:28:54.960 --> 00:28:55.600] Ah, okay.
[00:28:55.600 --> 00:28:56.640] Yeah, that makes sense.
[00:28:56.640 --> 00:29:03.040] So you're seeing X percent increase in both men and women, but you're starting from a lower point.
[00:29:03.040 --> 00:29:04.640] So the total amount is just smaller.
[00:29:04.640 --> 00:29:05.200] Your threshold.
[00:29:05.760 --> 00:29:11.040] If you've got your threshold set to men, then you don't, you might not even meet that threshold.
[00:29:11.040 --> 00:29:16.160] But if you've not compared it to your individual baseline, because we often don't, this is a problem with medicine just generally.
[00:29:16.160 --> 00:29:24.240] It's the same with various other things is when we're looking for an increase in a particular thing, well, you don't know what the patient's baseline was because you don't usually measure them earlier in their life.
[00:29:24.320 --> 00:29:25.440] I've seen them before they were.
[00:29:25.440 --> 00:29:31.600] So it might be elevated for that individual patient, but we're using population thresholds.
[00:29:31.600 --> 00:29:34.000] I am very much the opposite because I've got a very low pulse.
[00:29:34.000 --> 00:29:35.520] My pulse is obscenely low.
[00:29:35.520 --> 00:29:36.320] Take once a week.
[00:29:36.800 --> 00:29:37.200] Yeah.
[00:29:37.280 --> 00:29:38.160] Something along those lines.
[00:29:38.160 --> 00:29:40.560] No, my pulse typically is below 50.
[00:29:40.560 --> 00:29:43.760] It sometimes gets down as low as 42.
[00:29:44.080 --> 00:29:48.720] The lowest I've recorded it at is 38, which is ridiculous.
[00:29:48.960 --> 00:29:51.200] An average is like 60, 70.
[00:29:51.520 --> 00:29:56.560] And yeah, the average, I think, is like 72, I think, is like the population average for a pulse.
[00:29:56.560 --> 00:30:04.040] But it means every time I get my pulse taken at the doctor's, they comment going, Oh, you're, you know, your pulse is very low.
[00:30:04.040 --> 00:30:04.760] Are you an athlete?
[00:29:59.200 --> 00:30:05.720] And I say, well, no, I'm not.
[00:30:05.720 --> 00:30:09.240] And then the conversation kind of stops because they've got nowhere else to go after that, which is weird.
[00:30:09.240 --> 00:30:12.200] But if my pulse is 60, that's high.
[00:30:12.200 --> 00:30:13.080] Yeah, that's a bad thing.
[00:30:13.080 --> 00:30:16.680] But everyone else, the doctors will look at that and go, well, beautiful normal pulse there.
[00:30:16.680 --> 00:30:17.320] Thank you very much.
[00:30:17.320 --> 00:30:21.720] Because nobody knows that my pulse is fucking 38 or whatever it is, right?
[00:30:22.040 --> 00:30:35.960] Yeah, and it's a really important point that we need to get to grips with better in the medical world because as we start to talk more and more and more about individualized medicine, we also need to think about individualized like human baselines.
[00:30:35.960 --> 00:30:40.200] It comes up with things like testing to see if you're in paramenopause.
[00:30:40.200 --> 00:30:43.880] You don't know what the patient's baseline hormones are.
[00:30:43.880 --> 00:30:54.440] So they might have had low hormones for their entire life and then suddenly, well, it looks like they're in paramenopause, but they've always had low hormones or the other way around, right?
[00:30:54.440 --> 00:30:54.760] That's great.
[00:30:54.840 --> 00:30:59.240] But you've been promising to eventually get around to doing something about the Zoe app.
[00:30:59.240 --> 00:31:02.200] But by the time you get there, you're going to talk to yourself if you think it's a good idea.
[00:31:02.680 --> 00:31:06.440] We just need to get all the baselines on everybody all the time.
[00:31:07.400 --> 00:31:13.080] At the end of this segment, we can talk about my latest device because it's relevant to this topic.
[00:31:13.080 --> 00:31:13.880] The black armband you wear.
[00:31:16.280 --> 00:31:22.120] There are more sensitive forms of troponin testing that can help with this, and we should just be using those as standard.
[00:31:22.120 --> 00:31:26.680] So there are gender differences when it comes to identifying, diagnosing, and treating heart attacks.
[00:31:26.680 --> 00:31:30.920] But it's not as simple as women being different.
[00:31:30.920 --> 00:31:40.360] There are a range of different steps in the pathway that are vulnerable to medical bias, as well as issues with awareness and some biological differences, but not the ones that we think there are.
[00:31:40.360 --> 00:31:42.360] We definitely need to do more research in women.
[00:31:42.360 --> 00:31:50.560] According to the British Heart Foundation, historically, two-thirds of all clinical research has been carried out in men, and women have been underrepresented in cardiovascular clinical trials.
[00:31:50.560 --> 00:31:55.360] And there are fewer women who are cardiologists and all sorts of issues.
[00:31:55.360 --> 00:31:57.760] But two-thirds of medical research has been carried out in men.
[00:31:57.760 --> 00:32:01.280] That is actually, women are less underrepresented than I expected.
[00:32:01.280 --> 00:32:04.160] That means they're in a third, and they should be in about a half.
[00:32:04.160 --> 00:32:07.360] But bear in mind that some clinical research can only be done in women.
[00:32:07.360 --> 00:32:08.000] Yeah, that's fair.
[00:32:08.000 --> 00:32:08.560] That is fair.
[00:32:08.560 --> 00:32:10.480] Well, some can only be done in men.
[00:32:10.800 --> 00:32:13.280] Women very underrepresented in bollock research.
[00:32:13.280 --> 00:32:14.720] Very, very, very underrepresented.
[00:32:14.960 --> 00:32:16.240] Ridiculous.
[00:32:16.560 --> 00:32:22.720] But in the meantime, a realistic awareness of the issue is important in tackling the bias that women experience.
[00:32:26.880 --> 00:32:28.960] So, Alice, you've got an armband on.
[00:32:28.960 --> 00:32:30.000] I have got an armband on.
[00:32:30.080 --> 00:32:31.360] You've had an armband on.
[00:32:31.920 --> 00:32:35.120] For a while, we just thought you'd had some sort of tragedy and didn't want to make it.
[00:32:35.520 --> 00:32:36.080] I'm in mourning.
[00:32:36.080 --> 00:32:36.960] I'm in quite mourning.
[00:32:38.480 --> 00:32:43.280] We know you're not in mourning because we've heard at the start of this episode how you deal with family.
[00:32:43.280 --> 00:32:45.040] It wouldn't be a black arm.
[00:32:45.200 --> 00:32:48.160] Maybe you just joined some sort of fascist troop.
[00:32:48.160 --> 00:32:49.280] Don't say that.
[00:32:49.280 --> 00:32:51.120] I think it's the wrong arm for that.
[00:32:51.440 --> 00:32:56.000] I do have to swap arms occasionally because it gives my skin a bit of a rash.
[00:32:56.080 --> 00:32:57.440] Is there a particular fascist arm?
[00:32:57.680 --> 00:32:58.800] I bet there is.
[00:32:58.800 --> 00:33:00.000] I bet there is.
[00:33:00.000 --> 00:33:02.560] It's like the Nazis always wore it on one arm.
[00:33:02.560 --> 00:33:03.200] Okay.
[00:33:03.200 --> 00:33:08.560] I think if you were a Nati wearing your swastika roundband on the wrong arm, then that would be a four-part at best.
[00:33:08.560 --> 00:33:13.760] I tell you what, for a podcast that we've done just about women in heart attacks, we've mentioned the Holocaust and Nazis a lot.
[00:33:15.920 --> 00:33:17.440] It's just on our minds lately.
[00:33:17.440 --> 00:33:20.800] I wonder why that is, especially when it comes to like health and stuff.
[00:33:20.800 --> 00:33:22.080] So, what's your armband for?
[00:33:22.640 --> 00:33:25.360] My armband is possibly woo.
[00:33:25.360 --> 00:33:26.160] It's not.
[00:33:26.160 --> 00:33:27.160] I don't know that it is woo.
[00:33:27.040 --> 00:33:27.960] Acupressure.
[00:33:28.480 --> 00:33:29.160] It is.
[00:33:28.880 --> 00:33:30.520] It's a heart monitor.
[00:33:29.440 --> 00:33:31.800] It's a continuous heart monitor.
[00:33:32.120 --> 00:33:32.840] That's not where your heart is.
[00:33:33.160 --> 00:33:34.120] So that is woo.
[00:33:29.680 --> 00:33:37.160] You can measure heart rate under the skin.
[00:33:37.320 --> 00:33:40.040] So, like, the best place to wear a heart monitor is around your chest, obviously.
[00:33:40.120 --> 00:33:41.800] Yeah, but then you'll start thinking your bra is too tight.
[00:33:41.880 --> 00:33:43.160] You won't have a heart attack.
[00:33:43.800 --> 00:33:47.960] And then arms are pretty good for detecting with these kinds of monitors.
[00:33:47.960 --> 00:33:54.840] So, chronically ill listeners will have heard of this armband because it's all over social media.
[00:33:54.840 --> 00:33:59.160] And I have been absolutely influenced into buying this thing to some extent.
[00:33:59.480 --> 00:34:03.160] People who don't have chronic illness, when I mention it to them, have never heard of it.
[00:34:03.560 --> 00:34:08.440] This is absolutely targeted marketing for sure.
[00:34:08.760 --> 00:34:18.920] The idea is, and it's connected up to a specific app that is specifically claims to be specifically designed for people with chronic illness and claims to be the only one of its kind, and blah, blah, blah.
[00:34:18.920 --> 00:34:23.320] And that's, I think, there probably is a little bit of sensationalizing in the marketing.
[00:34:23.320 --> 00:34:32.440] But one thing that's important for people with chronic ill health is that the way your body exerts itself is slightly different to the average person.
[00:34:32.440 --> 00:34:33.800] But also, it's different for everybody.
[00:34:33.800 --> 00:34:35.240] Everybody is an individual person.
[00:34:35.240 --> 00:34:39.400] As we've just said, that our baselines differ from person to person.
[00:34:39.400 --> 00:34:49.080] And so, what this is claiming to do is capturing heart rate data continually, unlike a Fitbit which would check in every 10 minutes.
[00:34:49.080 --> 00:34:52.440] In which case, you might miss ten bits of key information.
[00:34:52.840 --> 00:34:57.720] Apple Watch does the same thing, just every so often rather than constantly.
[00:34:57.720 --> 00:35:09.880] Yeah, so this is checking in constantly, 100% of the time, and then it's doing some algorithmic stuff in terms of consolidating my personal data to give me what it thinks is what it calls a pace point budget.
[00:35:09.880 --> 00:35:21.280] So, if you've heard of spoon theory, it's kind of like turning spoon theory into numbers, actually guessing how much energy you have in any given day so that you can try and pace better.
[00:35:21.440 --> 00:35:25.760] The idea of when you have chronic illness, pacing is a key thing that you kind of need to learn.
[00:35:25.760 --> 00:35:37.040] It's something I have learned and do reasonably well with over the years that I've had my various conditions in the idea that you want to, on your very worst days, you want to push a little bit but not overdo it.
[00:35:37.360 --> 00:35:42.480] And on your very best days, you want to do below what you're able to so that eventually you level out.
[00:35:42.480 --> 00:35:49.280] You don't do these peaks and troughs where you keep overdoing it and ending up crashing out and having a terrible few days need to recover.
[00:35:49.280 --> 00:35:53.680] So, it's about monitoring how your body is exerting itself.
[00:35:53.680 --> 00:36:03.840] But what's really useful for me and for a lot of people with chronic illness is how I exert myself on a day-to-day basis changes wildly from day to day.
[00:36:03.840 --> 00:36:08.720] And I don't have any insight into that other than how I am feeling, which is subjective.
[00:36:08.720 --> 00:36:16.560] And I know it's subjective because I'm a sceptic and can talk rationalize myself out of actually giving myself the validation that I need sometimes.
[00:36:16.560 --> 00:36:23.680] So, being able to see that, well, yesterday when I cooked dinner, my heart rate was as if I was at rest.
[00:36:23.680 --> 00:36:27.680] Yeah, and today when I'm cooking dinner, I'm at high exertion level.
[00:36:27.680 --> 00:36:30.240] Sure, my heart rate is beating really fast.
[00:36:30.560 --> 00:36:41.680] I'm therefore using more energy doing basic day-to-day tasks than I am on a good day, and so I can modify my behavior accordingly, but also be a bit more compassionate to myself accordingly.
[00:36:41.680 --> 00:36:48.200] And also, know when I can push when, well, I feel like crap today, but actually, my heart rate's not pushing too much.
[00:36:48.000 --> 00:36:53.920] So, so maybe I can push a little bit further and trust myself that that's not going to push me into a massive crash.
[00:36:54.000 --> 00:36:59.080] The reason I've got it now is not just because I've been completely influenced by social media.
[00:36:59.080 --> 00:37:00.360] Obviously, partly that.
[00:36:59.680 --> 00:37:00.920] Partly that.
[00:36:59.840 --> 00:37:06.360] And I heard about it through social media months and months and months ago, and I've been dismissing it as, oh, it's probably Woo.
[00:37:06.520 --> 00:37:12.360] And then I've had some conversations with people about it, including Kat Ford, who asked me what I thought about it.
[00:37:12.360 --> 00:37:22.280] And I was like, I've not really looked into it yet, and I'm not sure how much I trust it because some of these ideas around how we live with chronic illness is still in its infancy in terms of research.
[00:37:22.280 --> 00:37:32.840] We don't know for sure that the heart rate exertion stuff, although we can see the differences, we don't necessarily know that trying to regulate that will have a long-term positive impact.
[00:37:32.840 --> 00:37:37.320] But I just got to the point where I've had two bouts of burnout this year.
[00:37:37.320 --> 00:37:41.400] I've been flaring up more often than usual.
[00:37:41.400 --> 00:37:47.240] This summer has been absolutely terrible, at least in part because the humidity has been affecting my symptoms so much worse than usual.
[00:37:47.480 --> 00:37:48.040] Indeed, yeah.
[00:37:48.440 --> 00:37:52.840] Partly because the humidity has been worse, but maybe because my body isn't doing as well at the minute.
[00:37:52.840 --> 00:37:56.520] And I just wanted to kind of figure out what's going on.
[00:37:56.520 --> 00:37:59.400] And I thought this was a way to get some of the data that might help me.
[00:37:59.400 --> 00:38:04.040] And I was really wary of it because I don't necessarily think I would recommend this forever.
[00:38:04.040 --> 00:38:06.920] I've only had it for two weeks, so I'm not recommending either way.
[00:38:07.480 --> 00:38:11.080] I don't, I haven't come to a conclusion on whether it's useful or not yet.
[00:38:11.080 --> 00:38:19.400] I'm seeing some value for me personally, but I wouldn't necessarily say that I'm going to get long-term value yet or whether I think it's useful for other people.
[00:38:19.400 --> 00:38:41.120] But one of the risks for a lot of people is having all of this data can increase health anxiety sometimes and can make you do less and then therefore deteriorate more because actually we do need to push beyond, gradually push safely beyond our limits sometimes when we have chronic illness.
[00:38:41.120 --> 00:38:46.640] So I don't think, I think if you have a certain type of psychology, it's probably an absolutely terrible thing.
[00:38:46.640 --> 00:38:47.840] I know my psychology.
[00:38:47.840 --> 00:38:53.200] I've spent years getting to grips with my chronic ill health and using Fitbits on and off.
[00:38:53.200 --> 00:38:56.640] Well, Fitbits, not even on and off, just on for years.
[00:38:56.960 --> 00:38:59.840] And I know how I use that data and information.
[00:38:59.840 --> 00:39:03.920] So I thought it might be useful to help me manage my condition better.
[00:39:03.920 --> 00:39:08.160] But it's all from this idea of everybody is individually different.
[00:39:08.160 --> 00:39:09.280] And this is a piece of data.
[00:39:09.280 --> 00:39:13.120] And actually, I say it's taking all this data, but actually, it's taking two measurements.
[00:39:13.120 --> 00:39:15.120] It's giving me a continual heart rate measurement.
[00:39:15.360 --> 00:40:17.880] And then in the morning, it checks my heart rate variability to and then it sure yeah incorporates some subjective stuff that I input into it but for the most part those are the only two things it's measuring and we'll see if it's useful or not excellent so listeners if you want to get your on bro we've got an offer called we haven't got imagine if we could do an ad for a deck that was how we started doing ads on the show this episode of skeptic sponsored by alice's black armband try alice's black armband i have very specifically not uh named it or endorsed chronic illness listeners will know what i'm talking about and i'm very happy for people to get in touch and ask ask me questions about it if they're thinking about it for themselves or whatever but i'm very much not endorsing it yet i would love if they'd sent it me free because it was it's not cheap it's a subscription model on the app and then you buy the band as well so it's it's it'll work for me with pepsi and a wife so we'll give it a shot why not what i will say is throw ahead to a future show in a in a couple of weeks' time.
[00:40:17.880 --> 00:40:21.240] I'm going to be talking about a device that i'm now showing.
[00:40:21.400 --> 00:40:22.600] It looks very similar to mine.
[00:40:22.760 --> 00:40:27.400] That is a little black box with a black velcro strap that you wear around one of your story.
[00:40:27.560 --> 00:40:28.280] That's fascinating.
[00:40:28.280 --> 00:40:29.000] That is where i'm going.
[00:40:29.000 --> 00:40:31.400] So, you know, come back in a couple of weeks and you hear that.
[00:40:31.640 --> 00:40:33.480] Come back next week and hear my story as well.
[00:40:33.480 --> 00:40:37.800] But then come back the week after and you hear me shit all over the thing that Alice is wearing.
[00:40:37.800 --> 00:40:38.200] No, it's not.
[00:40:38.200 --> 00:40:40.280] It's just a different device.
[00:40:40.280 --> 00:40:42.760] So, yeah, that is what my black armband is.
[00:40:42.760 --> 00:40:50.040] But it's also telling me useful things like when I went to help with your gardening a couple of weeks ago and my heart rate just went, fuck off.
[00:40:50.040 --> 00:40:50.920] What are you doing?
[00:40:50.920 --> 00:40:52.040] Why are you doing so?
[00:40:52.360 --> 00:40:54.440] They take useful things like you overdid it that day.
[00:40:54.760 --> 00:40:58.920] I'm glad you needed a little box that you pay to put on your arm to say that you overdid it that day.
[00:40:59.320 --> 00:41:00.760] The fact that I couldn't move for like a week after that.
[00:41:01.080 --> 00:41:03.560] I was like, I don't think you should be doing it for as long as you are there, Alice.
[00:41:03.560 --> 00:41:04.840] No, it's fine.
[00:41:04.840 --> 00:41:15.480] Well, that was that was my that was quite important therapeutically because, as I say, I've been really struggling with my health recently.
[00:41:15.480 --> 00:41:18.920] And part of that is I overdo things and I'm terrible at not overdoing things.
[00:41:18.920 --> 00:41:23.480] And part of it is that my work is chaotic and I've had to do a lot of traveling recently.
[00:41:23.480 --> 00:41:28.040] And part of it is that I think my body has changed and I've got to get to grips with a change.
[00:41:28.040 --> 00:41:36.120] But it's really difficult psychologically when you have disabilities to adjust to those changes sometimes because it's really fucking frustrating.
[00:41:36.120 --> 00:41:41.080] I've spent years getting things under control and managed to get to a point where I live a relatively normal life.
[00:41:41.080 --> 00:41:44.520] It affects me every single day, but it doesn't have to affect other people in my life.
[00:41:44.520 --> 00:41:48.440] I managed to like deal with that and keep it under control and stuff.
[00:41:48.440 --> 00:41:51.880] And then suddenly something's changed and everything's gone haywire.
[00:41:51.880 --> 00:41:53.800] And frankly, it's not fucking fair.
[00:41:53.800 --> 00:41:54.760] And I really hate it.
[00:41:54.760 --> 00:41:58.440] And I was going through a really emotionally difficult spell with it.
[00:41:58.440 --> 00:42:00.760] And then we went to yours to help do the gardening.
[00:42:00.760 --> 00:42:01.880] And I was like, Fuck this.
[00:42:01.880 --> 00:42:03.480] And I'm getting all this information.
[00:42:03.480 --> 00:42:05.160] And it's telling me I shouldn't do anymore.
[00:42:05.160 --> 00:42:06.440] And it can fuck the fuck off.
[00:42:06.440 --> 00:42:10.200] And I threw a tantrum and I did some gardening, and I paid for it afterwards.
[00:42:10.200 --> 00:42:12.680] But it was really, really cathartic.
[00:42:13.000 --> 00:42:17.840] And I'm glad I did it, even though I paid for it for like a week afterwards.
[00:42:19.440 --> 00:42:33.280] But it was that cathartic nature of it has now allowed me to be like, okay, I've got that on my system, and now I can just be a grown-up and learn how to live with the changes that I'm going through and figure out how to get back onto an even keel and feel positive about that.
[00:42:33.280 --> 00:42:34.560] Because before that, I was just miserable.
[00:42:34.560 --> 00:42:35.760] I was just like, it's not fair.
[00:42:35.760 --> 00:42:36.640] Why do I have to do this?
[00:42:36.640 --> 00:42:38.000] Why do I have to be disabled?
[00:42:38.000 --> 00:42:39.280] Why does it have to affect my job?
[00:42:39.280 --> 00:42:44.480] And the things that I actually want to do or the ways that I show up for other people, that's not fair.
[00:42:44.480 --> 00:42:46.720] I'm just self-pity party.
[00:42:47.360 --> 00:42:48.080] I'm through that now.
[00:42:48.080 --> 00:42:49.920] I've thrown it all at your garden.
[00:42:49.920 --> 00:42:50.640] You did.
[00:42:50.640 --> 00:42:51.440] You did.
[00:42:55.920 --> 00:43:02.320] So, Liverpool Skeptics at the pub this evening, we've got an event going on at the CASA, and that is going to be Kaylene Devlin.
[00:43:02.480 --> 00:43:04.800] Yes, from the BBC's Verify service.
[00:43:04.800 --> 00:43:06.480] We've had some people from the BBC come along.
[00:43:06.800 --> 00:43:18.640] Over the years, we've had a couple of BBC folk, and they're always interesting the insights into the work they do and how they fact-check stuff and how they go about getting to the bottom of misinformation that they're finding in a very politically charged environment.
[00:43:18.640 --> 00:43:20.880] So, I'm sure that'll be a really interesting one as well.
[00:43:20.880 --> 00:43:21.360] Yeah.
[00:43:21.360 --> 00:43:23.440] So, that's going to be in the CASA from eight o'clock.
[00:43:23.440 --> 00:43:26.400] And if you're in the Liverpool area, you should definitely come along to that.
[00:43:26.400 --> 00:43:28.240] We'll be excited to see you.
[00:43:28.240 --> 00:43:32.000] Also, tickets for QED, streaming tickets for QED are still available.
[00:43:32.000 --> 00:43:33.680] You can find those at QEDCon.org.
[00:43:33.680 --> 00:43:37.360] That gives you access to most of the content that we have available.
[00:43:37.360 --> 00:43:41.040] I think the only thing that we don't put on the stream is the workshops because it kind of doesn't fit.
[00:43:41.040 --> 00:43:45.040] Yeah, there may be a couple of speakers who can't stream their work for various reasons.
[00:43:45.040 --> 00:43:46.800] So, we'll announce that ahead of time.
[00:43:46.800 --> 00:43:50.640] But other than that, you'll get absolutely everything-the panels, the podcasts.
[00:43:50.640 --> 00:43:52.720] I don't know if I can stream my talk yet.
[00:43:52.720 --> 00:43:53.440] Yes, you can.
[00:43:53.440 --> 00:43:54.280] I don't know about it.
[00:43:54.160 --> 00:43:54.760] No, you can't.
[00:43:54.880 --> 00:43:55.760] I think I can.
[00:43:55.760 --> 00:43:57.440] I don't know if I can record it.
[00:43:57.440 --> 00:43:58.160] Yes, you can.
[00:43:58.160 --> 00:43:58.840] No.
[00:43:58.480 --> 00:44:05.240] My talk may contain quite libelous stuff.
[00:44:06.120 --> 00:44:09.000] In which case, we should probably replace you with another speaker, mate.
[00:44:09.240 --> 00:44:10.440] In all honesty.
[00:44:10.440 --> 00:44:13.400] I'm going to try not to be libelous.
[00:44:14.600 --> 00:44:20.680] Yeah, so you can find details about that at qdcon.org, where you'll also find we've made a new announcement this week as well, which is good.
[00:44:20.680 --> 00:44:21.960] We've announced two new speakers.
[00:44:21.960 --> 00:44:22.360] We have.
[00:44:22.760 --> 00:44:24.200] Our final two new speakers.
[00:44:24.520 --> 00:44:25.240] Our final.
[00:44:25.880 --> 00:44:26.280] No.
[00:44:26.280 --> 00:44:26.760] No.
[00:44:26.760 --> 00:44:27.880] We've got four more to announce.
[00:44:28.200 --> 00:44:28.760] Four more to announce.
[00:44:28.920 --> 00:44:29.480] We've announced.
[00:44:29.480 --> 00:44:30.360] Two of which we have announced.
[00:44:30.920 --> 00:44:31.720] Should we talk about them now?
[00:44:32.280 --> 00:44:33.400] Should we do them now?
[00:44:33.400 --> 00:44:43.480] So the first speaker that we've got to announce is somebody who came and did a talk for us at Merseyside Skeptics a few months ago, and she was absolutely brilliant, which is why we've got her back for QED and that is Emma McLaughlin.
[00:44:43.480 --> 00:44:58.840] I think we've talked about Emma McLaughlin loads on this show because we first talked about her when Marsha and I went to a festival in the Lake District at Moncaster Castle, which as part of that festival, we went to see the predatory bird show that they do.
[00:44:58.840 --> 00:45:01.000] And it was incredible.
[00:45:01.000 --> 00:45:09.880] And Emma's passion and enthusiasm and knowledge around vultures is just incredible.
[00:45:10.360 --> 00:45:17.560] And I don't know how to get across to listeners how incredible a speaker she is because it's about a topic many, like loads of our listeners will love.
[00:45:17.560 --> 00:45:23.160] Loads of our listeners will love birds of prey, but loads of our listeners will be like, what the fuck have birds of prey got to do with skepticism?
[00:45:23.160 --> 00:45:24.520] And no one cares about vultures.
[00:45:24.520 --> 00:45:26.200] And no one cares about vultures.
[00:45:26.200 --> 00:45:36.920] So it's hard to explain how just amazing she is to watch because that passion is just exudes from her and it makes you passionate about vultures.
[00:45:36.920 --> 00:45:40.920] Like, I love vultures now because she is so great at communicating.
[00:45:41.320 --> 00:45:42.680] At the MSS, we paid to adopt.
[00:45:43.000 --> 00:45:44.560] Our lovely two gay boys.
[00:45:44.200 --> 00:45:48.800] We've got two gay vultures, which we talked about on the show as well.
[00:45:49.520 --> 00:45:52.560] Yeah, because nobody adopts vultures, nobody conservation efforts.
[00:45:52.560 --> 00:45:58.800] People don't put their money towards vultures, they put it towards the pretty, shiny, cute things, and they think vultures erg.
[00:45:58.960 --> 00:45:59.920] But vultures are important.
[00:45:59.920 --> 00:46:02.160] So, yeah, lovely vulture lady.
[00:46:02.160 --> 00:46:04.080] I highly recommend seeing that talk.
[00:46:04.080 --> 00:46:08.000] She's an amazing speaker, and it will be a great, a great session.
[00:46:08.000 --> 00:46:10.240] Yeah, that's going to be an absolutely fantastic time.
[00:46:10.240 --> 00:46:16.240] The other speaker that we've got to announce quite fantastically, because she's doing my panel, is Lucia Osborne Crowley.
[00:46:16.240 --> 00:46:18.080] Yes, we haven't talked about your panel, and we're not going to talk about your panel.
[00:46:18.240 --> 00:46:23.600] We're not going to talk about your panel, but we are going to talk about Lucia, who I'm also really, really excited about.
[00:46:23.600 --> 00:46:32.480] I first came across Lucia when our good friend Robin Ince posted on social media that everybody in the world must read her book.
[00:46:32.480 --> 00:46:37.280] She's written a book about the trial of Gillaine Maxwell, and I would have completely skimmed over that.
[00:46:37.280 --> 00:46:39.920] I would have gone, that's a bit garish.
[00:46:39.920 --> 00:46:42.240] I don't want to, like, it's a bit like rubbernecking.
[00:46:42.240 --> 00:46:44.880] I'm not sure I want to read about this trial.
[00:46:44.880 --> 00:46:49.920] Not necessarily particularly interested in the Epstein stuff generally.
[00:46:49.920 --> 00:46:51.920] Yeah, I would have agreed with you, yeah.
[00:46:51.920 --> 00:46:55.760] But Robin recommended it, and so I was like, and really highly recommended it.
[00:46:55.760 --> 00:46:57.440] So I was like, I'm going to listen to the audiobook.
[00:46:57.440 --> 00:47:01.200] And I listened to the audiobook, and it was an incredible piece of work.
[00:47:01.200 --> 00:47:05.680] She went to that trial every single day, but she's one of the few journalists who was there the whole time.
[00:47:05.840 --> 00:47:10.880] One of the few journalists who was able to be in the room because only six journalists or something were allowed to be in the room.
[00:47:10.880 --> 00:47:13.280] She was in the room every single day, getting up at like 2 a.m.
[00:47:13.360 --> 00:47:16.640] to get there, to get in the queue, to get into the room.
[00:47:16.960 --> 00:47:22.480] But she has this amazing personal experience that she talks about in relation to that story.
[00:47:22.480 --> 00:47:35.160] But also, she's spoken to so many of the victims and built that story around them and really telling it from the impact side of it and talking about the victims at the front and center and why she wants to report it is because of that.
[00:47:35.320 --> 00:47:40.120] It's just she's a great storyteller, but also she's got such compassion for that experience.
[00:47:40.120 --> 00:47:42.440] And it's a really interesting story the way she tells it.
[00:47:42.440 --> 00:47:45.160] Yeah, and I think it's at a very important time.
[00:47:45.160 --> 00:47:47.880] That's why we're so keen to have her at this QED.
[00:47:47.880 --> 00:47:55.160] I mean, I spend a lot of time, I am interested in the Epstein stuff because of the ripple effect it's having through the conspiratorial world.
[00:47:55.160 --> 00:47:56.920] And so I watch a lot of Joe Rogan.
[00:47:56.920 --> 00:47:58.200] Joe Rogan talks about it a lot.
[00:47:58.360 --> 00:47:59.880] The people he talks to talk about it a lot.
[00:47:59.880 --> 00:48:09.000] But whenever they talk about Epstein and even Maxwell, they never talk about the victims ever because the victims don't exist to them.
[00:48:09.000 --> 00:48:13.160] The victims are just pieces in the chess game, but not real people.
[00:48:13.160 --> 00:48:24.440] To the point where Joe Rogan and people like him specifically talk about, well, Epstein was sent down for being a predator and she was sent down for being for trafficking, but trafficking to who?
[00:48:24.440 --> 00:48:25.640] Because there were no clients.
[00:48:25.640 --> 00:48:28.840] So how has she been done for trafficking when she wasn't trafficking them to anyone?
[00:48:29.000 --> 00:48:31.480] Seems pretty clear that there's people missing from this equation.
[00:48:31.480 --> 00:48:34.440] It's like, no, she was trafficking them to him.
[00:48:34.440 --> 00:48:36.360] She was trafficking them for him.
[00:48:36.360 --> 00:48:44.200] You don't care about the story enough because you just see it as this salacious story of like, oh, the intrigue and the conspiracy and all the details.
[00:48:44.200 --> 00:48:45.880] But these are real people.
[00:48:45.880 --> 00:48:47.400] And the real details are out there.
[00:48:47.400 --> 00:48:49.880] If you like, lots of the real details are out there and you don't care.
[00:48:50.600 --> 00:49:00.120] And that's what I'd worried about when, like, well, that's why I maybe wouldn't have read the book before because it is quite mawkish potentially to just listen to a trial about that.
[00:49:00.120 --> 00:49:07.880] But to send to center the victims in it in the way that she did, and very strongly center the victims in it, much more than any story.
[00:49:07.880 --> 00:49:10.440] None of the stories really about Ghillette Maxwell.
[00:49:10.440 --> 00:49:17.680] She kind of flits into the story, but the story is about the victims and the impact that's had on them.
[00:49:14.840 --> 00:49:20.560] But it just really lays out those details.
[00:49:20.800 --> 00:49:35.440] And also, I've found it fascinating learning about how the American trial system works and how those court cases actually play out and stuff and the decisions that were made and how the various barristers have made the decisions that they've made and how they've presented the story.
[00:49:35.440 --> 00:49:37.280] It's absolutely fascinating.
[00:49:37.280 --> 00:49:44.880] Yeah, and we had to have her at this QED because Ghillay Maxwell probably won't be in prison if we ever did another event because she's on her way towards full release.
[00:49:45.200 --> 00:49:49.440] So, yes, if you're coming to QED, you can look forward to seeing those two people on stage.
[00:49:49.680 --> 00:49:51.040] We will also be at QED.
[00:49:51.040 --> 00:49:51.440] We will.
[00:49:51.440 --> 00:49:51.920] I should hope.
[00:49:51.920 --> 00:49:53.440] Last year, we very nearly weren't.
[00:49:53.440 --> 00:49:53.840] Yes.
[00:49:54.160 --> 00:49:57.120] Which was entertaining because we all came down with COVID about a week before we.
[00:49:57.200 --> 00:49:58.160] I did not get COVID.
[00:49:58.160 --> 00:49:59.200] You two got COVID.
[00:50:00.000 --> 00:50:04.800] I probably will again, but we're going to get vaccinated in the month of August.
[00:50:04.800 --> 00:50:06.080] Yeah, very soon.
[00:50:06.080 --> 00:50:06.800] In advance, yeah.
[00:50:06.960 --> 00:50:08.400] Gonna get vaccinated early doors.
[00:50:08.400 --> 00:50:13.200] But yes, if you haven't got a QED ticket, you can buy your online ticket at QDCon.org.
[00:50:13.520 --> 00:50:15.600] Aside from that, then I think that's all we've got time for.
[00:50:15.600 --> 00:50:16.160] I think so.
[00:50:16.160 --> 00:50:18.640] All that remains then is to thank March for coming along today.
[00:50:18.640 --> 00:50:19.120] Cheers.
[00:50:19.120 --> 00:50:20.000] Thank you to Alice.
[00:50:20.000 --> 00:50:20.560] Thank you.
[00:50:20.560 --> 00:50:23.200] We have been Skeptics with a K, and we will see you next time.
[00:50:23.200 --> 00:50:23.840] Bye, no.
[00:50:23.840 --> 00:50:24.640] Bye.
[00:50:29.440 --> 00:50:34.560] Skeptics with a K is produced by Skeptic Media in association with the Merseyside Skeptic Society.
[00:50:34.560 --> 00:50:43.760] For questions or comments, email podcast at skepticswithakay.org and you can find out more about Merseyside Skeptics at merseyside skeptics.org.uk.

Prompt 2: Key Takeaways

Now please extract the key takeaways from the transcript content I provided.

Extract the most important key takeaways from this part of the conversation. Use a single sentence statement (the key takeaway) rather than milquetoast descriptions like "the hosts discuss...". 

Limit the key takeaways to a maximum of 3. The key takeaways should be insightful and knowledge-additive. 

IMPORTANT: Return ONLY valid JSON, no explanations or markdown. Ensure:
- All strings are properly quoted and escaped
- No trailing commas
- All braces and brackets are balanced
Format: {"key_takeaways": ["takeaway 1", "takeaway 2"]}

Prompt 3: Segments

Now identify 2-4 distinct topical segments from this part of the conversation.

For each segment, identify:
- Descriptive title (3-6 words)  
- START timestamp when this topic begins (HH:MM:SS format)
- Double check that the timestamp is accurate - a timestamp will NEVER be greater than the total length of the audio
- Most important Key takeaway from that segment. Key takeaway must be specific and knowledge-additive.
- Brief summary of the discussion

IMPORTANT: The timestamp should mark when the topic/segment STARTS, not a range. Look for topic transitions and conversation shifts.

Return ONLY valid JSON. Ensure all strings are properly quoted, no trailing commas:
{
  "segments": [
    {
      "segment_title": "Topic Discussion", 
      "timestamp": "01:15:30",
      "key_takeaway": "main point from this segment",
      "segment_summary": "brief description of what was discussed"
    }
  ]
}

Timestamp format: HH:MM:SS (e.g., 00:05:30, 01:22:45) marking the START of each segment.

Prompt 4: Media Mentions

Now scan the transcript content I provided for ACTUAL mentions of specific media titles:

Find explicit mentions of:
- Books (with specific titles)
- Movies (with specific titles)  
- TV Shows (with specific titles)
- Music/Songs (with specific titles)

DO NOT include:
- Websites, URLs, or web services
- Other podcasts or podcast names

IMPORTANT: 
- Only include items explicitly mentioned by name. Do not invent titles.
- Valid categories are: "Book", "Movie", "TV Show", "Music"
- Include the exact phrase where each item was mentioned
- Find the nearest proximate timestamp where it appears in the conversation
- THE TIMESTAMP OF THE MEDIA MENTION IS IMPORTANT - DO NOT INVENT TIMESTAMPS AND DO NOT MISATTRIBUTE TIMESTAMPS
- Double check that the timestamp is accurate - a timestamp will NEVER be greater than the total length of the audio
- Timestamps are given as ranges, e.g. 01:13:42.520 --> 01:13:46.720. Use the EARLIER of the 2 timestamps in the range.

Return ONLY valid JSON. Ensure all strings are properly quoted and escaped, no trailing commas:
{
  "media_mentions": [
    {
      "title": "Exact Title as Mentioned",
      "category": "Book",
      "author_artist": "N/A",
      "context": "Brief context of why it was mentioned",
      "context_phrase": "The exact sentence or phrase where it was mentioned",
      "timestamp": "estimated time like 01:15:30"
    }
  ]
}

If no media is mentioned, return: {"media_mentions": []}

Full Transcript

[00:00:00.240 --> 00:00:01.680] Looking for an easy escape?
[00:00:01.680 --> 00:00:06.800] Orange County, New York is just an hour from New York City and packed with unforgettable family fun.
[00:00:06.800 --> 00:00:14.640] Begin your adventure at picocny.com and build lasting memories at Legoland, New York, where Lego creations bring imagination to life.
[00:00:14.640 --> 00:00:18.480] Race go-karts and battle it out in LaserTag at the Castle Fun Center.
[00:00:18.480 --> 00:00:23.360] Or visit our charming farms to meet friendly animals, explore corn mazes, hayrides, and more.
[00:00:23.360 --> 00:00:27.200] With so much to discover, the only hard part is choosing where to begin.
[00:00:27.200 --> 00:00:30.400] Start planning now at picocny.com.
[00:00:37.440 --> 00:00:46.160] It is Thursday, the 21st of August, 2025, and you're listening to Skeptics with a K, the podcast for science, reason, and critical thinking.
[00:00:46.160 --> 00:00:58.160] Skeptics with a K is produced by Skeptic Media in association with the Merseyside Skeptic Society, a non-profit organization for the promotion of scientific skepticism on Merseyside, around the UK and internationally.
[00:00:58.160 --> 00:00:59.440] I'm your host, Mike Hall.
[00:00:59.440 --> 00:01:00.800] With me today is Marsh.
[00:01:00.800 --> 00:01:01.360] Hello.
[00:01:01.360 --> 00:01:02.160] And Alice.
[00:01:02.160 --> 00:01:02.720] Hello.
[00:01:03.040 --> 00:01:07.600] And this is the, I think this might be the longest we've gone in a while with just a regular lineup.
[00:01:07.760 --> 00:01:08.640] Sure, yeah, that's true.
[00:01:09.440 --> 00:01:12.480] We've not had a guest host on at all this year in 2025.
[00:01:12.720 --> 00:01:13.920] Now, zero of them.
[00:01:14.080 --> 00:01:16.480] The new world, you know, new order that we have.
[00:01:16.480 --> 00:01:17.120] But there we go.
[00:01:17.120 --> 00:01:18.720] It's not exciting times.
[00:01:18.720 --> 00:01:20.000] You know, we probably should.
[00:01:20.000 --> 00:01:21.520] Other people have got opinions.
[00:01:22.880 --> 00:01:24.400] And experience and expertise.
[00:01:24.400 --> 00:01:25.680] Yeah, do they matter?
[00:01:27.520 --> 00:01:31.120] So, listeners may remember that a few years ago, my granddad died.
[00:01:31.120 --> 00:01:33.040] During the last few years of his life, he had.
[00:01:35.760 --> 00:01:37.600] Jesus, that was a very cheery day.
[00:01:37.920 --> 00:01:39.040] He was a very old man.
[00:01:39.600 --> 00:01:42.240] People remember a few years ago, the Holocaust happened.
[00:01:42.800 --> 00:01:43.600] Wasn't that?
[00:01:43.920 --> 00:01:45.360] You might remember.
[00:01:45.680 --> 00:01:50.960] I'm just hoping to trick the listeners into thinking it's not as sad a story as it begins.
[00:01:51.200 --> 00:01:54.400] It's not as, I mean, we'll get to it.
[00:01:54.400 --> 00:02:00.000] During the last years of his life, he'd settled down with a woman called Pauline, who lived down in Cornwall.
[00:02:00.040 --> 00:02:05.880] So, my granddad had lived in France for decades, but eventually moved to Cornwall to live in the place that made his partner feel at home.
[00:02:05.880 --> 00:02:07.800] And Pauline was a really fascinating woman.
[00:02:07.800 --> 00:02:10.440] She was incredibly smart, but also incredibly well-read.
[00:02:10.440 --> 00:02:15.320] So the conversation could wander a million miles from where it started, always taking interesting twists and turns.
[00:02:15.320 --> 00:02:26.360] But she was also a woman with very severe anxiety and depression, for which, at the time of her death, almost a year to the day after my granddad passed, she was about to undergo electroconvulsive therapy to help treat.
[00:02:28.120 --> 00:02:30.840] This isn't a story about electroconvulsive therapy.
[00:02:30.840 --> 00:02:31.400] Okay.
[00:02:32.040 --> 00:02:34.680] Although maybe it is something we will cover in the future.
[00:02:34.680 --> 00:02:38.280] When Pauline died, she was experiencing symptoms of a heart attack.
[00:02:38.600 --> 00:02:45.800] And her friend, who was a nurse, was well aware that she was having symptoms of a heart attack and raised the medical alarms to get the medical support that she needed.
[00:02:45.800 --> 00:02:51.320] Unfortunately, the medical professionals didn't agree that she was having a heart attack and dismissed her symptoms as anxiety.
[00:02:52.040 --> 00:02:54.680] Ultimately, Pauline died a few days later.
[00:02:54.680 --> 00:02:59.800] And I don't know the medical ins and outs of her case, but I do know that her experience is not uncommon.
[00:02:59.800 --> 00:03:00.440] Yeah, yeah.
[00:03:00.440 --> 00:03:10.680] A study out of the University of Leeds published in 2016 looked at 564,412 patients with acute myocardial infarction, heart attack.
[00:03:10.680 --> 00:03:18.920] And Professor Gale, one of the study authors, said, This nationwide research shows that women are at a higher risk of being misdiagnosed following a heart attack than men.
[00:03:18.920 --> 00:03:27.560] When women with heart attack receive the wrong initial diagnosis, there are potentially important clinical repercussions, including an increased risk of death.
[00:03:27.880 --> 00:03:33.800] That's reassuring for me because I'm now worried that what I think is anxiety is actually a heart attack.
[00:03:33.800 --> 00:03:34.200] Okay.
[00:03:34.600 --> 00:03:37.240] But probably just anxiety.
[00:03:38.200 --> 00:03:44.960] And we will come back to symptoms so that you can be reassured that your symptoms are actually of anxiety.
[00:03:44.960 --> 00:03:45.440] Or maybe not.
[00:03:45.600 --> 00:03:46.080] Maybe you can.
[00:03:46.320 --> 00:03:47.040] Maybe I'm having a heart attack.
[00:03:47.120 --> 00:03:48.320] Maybe you're having a heart attack.
[00:03:48.320 --> 00:03:49.680] Just allow 15 years.
[00:03:50.000 --> 00:03:51.920] One constant slow heart attack.
[00:03:44.680 --> 00:03:52.080] Yeah.
[00:03:52.720 --> 00:04:03.040] So this research showed that women who had a final diagnosis of one particular type of myocardial infarction had a 59% greater chance of misdiagnosis compared with men.
[00:04:03.200 --> 00:04:03.520] Wow.
[00:04:03.520 --> 00:04:04.000] Okay.
[00:04:04.000 --> 00:04:12.960] And women who had a final diagnosis of the other type of myocardial infarction had a 41% greater chance of a misdiagnosis when compared with men.
[00:04:13.280 --> 00:04:16.880] And when it comes to myocardial infarction, early diagnosis is crucial.
[00:04:16.880 --> 00:04:28.400] So the same study found that in total, 168,534 or 29.9% of patients had an initial diagnosis which was not the same as their final diagnosis.
[00:04:28.400 --> 00:04:33.600] So in total, almost a third of patients were misdiagnosed in the first instance.
[00:04:33.600 --> 00:04:38.880] And they looked at two different types of myocardial infarction, and we are going to come to definitions later.
[00:04:38.880 --> 00:04:51.360] But they found that of those who were originally misdiagnosed but turned out to have one of the types of heart attack, the one-year mortality rate was more than double that of those who were diagnosed correctly in the first place.
[00:04:51.360 --> 00:04:53.920] So 25.5% compared to 10.7%.
[00:04:53.920 --> 00:04:57.760] So still reasonably good numbers, but a much bigger risk.
[00:04:57.760 --> 00:05:03.840] Other studies have also shown a disparity in diagnosis and treatment between men and women when it comes to heart attack symptoms.
[00:05:03.840 --> 00:05:16.080] So in 2022, a paper published in the Journal of the American Heart Association concluded that women and people of colour with chest pain waited longer to be seen by physicians independent of clinical features.
[00:05:16.080 --> 00:05:21.360] Women were independently less likely to be admitted when presenting with chest pain.
[00:05:21.360 --> 00:05:30.000] So they're less likely to go to the emergency department, but they're also less likely to be actually admitted once they've presented with chest pain.
[00:05:30.440 --> 00:05:38.040] This is based on a study looking at 101,372 emergency department visits over the course of four years.
[00:05:38.040 --> 00:05:47.400] Of those, they identified 4,152 emergency department visits, which were for adults aged 18 to 55 years with chest pain.
[00:05:47.400 --> 00:06:00.840] And because of their methodology, the statistical methodology, which is just statistical wizardry to me, they say that these visits represent 29 million emergency department visits in the probability matched national population.
[00:06:01.800 --> 00:06:06.200] Their study was looking both at disparities between genders and between race.
[00:06:06.200 --> 00:06:13.560] And we should be clear here that while I'm specifically talking about gender differences today, the disparity for people of colour is present and significant.
[00:06:13.560 --> 00:06:21.160] And I absolutely do not want to understate that people of colour are subjected to significant medical bias and it shows up everywhere.
[00:06:21.160 --> 00:06:22.440] It shows up here as well, of course.
[00:06:22.600 --> 00:06:23.880] Yeah, yeah, for sure.
[00:06:24.520 --> 00:06:25.720] So what's going on?
[00:06:25.720 --> 00:06:30.520] Why don't women get diagnosed properly when it comes to heart attack symptoms?
[00:06:30.600 --> 00:06:32.280] I'm asking you directly.
[00:06:32.680 --> 00:06:34.760] Their pain is disbelieved.
[00:06:34.760 --> 00:06:36.280] That's definitely part of it.
[00:06:36.280 --> 00:06:36.840] Sure.
[00:06:36.840 --> 00:06:45.080] I would imagine it's because the model symptom picture is based on the symptoms as they present in men.
[00:06:45.080 --> 00:06:46.360] And so women have different symptoms.
[00:06:46.680 --> 00:06:50.040] And so women would have a different symptom picture, which doesn't match the men's symptom picture.
[00:06:50.040 --> 00:06:51.640] So well, it's not a heart attack then.
[00:06:51.640 --> 00:06:58.040] Which would be because a lot of clinical research will be done just on men to exclude gender as a variable.
[00:06:58.040 --> 00:06:58.840] Yes.
[00:06:58.840 --> 00:07:06.600] And you'd think that, wouldn't you, from all the talk that gets shared around feminist spaces, that is what we are led to believe is the cause for that disparity.
[00:07:06.840 --> 00:07:07.960] That's my understanding.
[00:07:07.960 --> 00:07:09.680] Yeah, so I don't know.
[00:07:09.760 --> 00:07:16.160] I'm surprised, I'd be surprised by that, because I'd be surprised if the symptoms of heart attack in women were particularly different from men.
[00:07:17.520 --> 00:07:19.920] Therein is my piece for today.
[00:07:14.760 --> 00:07:20.080] Okay.
[00:07:20.640 --> 00:07:24.240] So this has been a piece that I've been meaning to write for ages.
[00:07:24.240 --> 00:07:29.920] And the reason I finally got around to it was because I was listening to a feminist podcast that usually does pretty well at being skeptical.
[00:07:29.920 --> 00:07:31.040] And I heard this misconception.
[00:07:31.040 --> 00:07:36.480] And I hear this a lot from people in feminist spaces and in skeptical spaces that, you know, women just have different heart attack symptoms.
[00:07:36.480 --> 00:07:39.680] The reason we don't diagnose women is because women have different heart attack symptoms.
[00:07:40.080 --> 00:07:40.560] Why would they?
[00:07:40.800 --> 00:07:47.440] The problem is laid out that broadly speaking, where women have heart attacks, their symptoms are atypical compared to the symptoms that men have.
[00:07:47.440 --> 00:07:50.320] So the cause of misdiagnosis, therefore, is simple.
[00:07:50.320 --> 00:07:56.400] We do all our medical research in men and we do all our medical education on the experience of men, particularly white men, of course.
[00:07:56.400 --> 00:07:58.640] And so we miss what's happening.
[00:07:58.640 --> 00:08:02.160] We miss the picture in women because women are different and weird in some way.
[00:08:02.160 --> 00:08:06.320] I don't understand how that would possibly be true because the heart isn't that mysterious.
[00:08:07.040 --> 00:08:18.640] I could imagine it would be if there was something that was, you know, one of your glands that produces different types of hormones, and the way that hormone would play out in the body is going to be different for women than men because of the way that the mix of hormones in a woman than a man.
[00:08:18.640 --> 00:08:21.520] But a heart is just a pump that sends blood around the body.
[00:08:21.680 --> 00:08:26.960] And blood is the same, and the body, like I said, the circulatory system isn't massively different.
[00:08:26.960 --> 00:08:28.880] So some of it comes from the idea.
[00:08:28.880 --> 00:08:32.000] So we do know that heart attacks are less common in women than men.
[00:08:32.000 --> 00:08:35.440] They're still really, really fucking common in women, but they're less common in women than men.
[00:08:35.440 --> 00:08:39.440] And then people start to run away with the bias and the ideas behind that.
[00:08:39.520 --> 00:08:41.760] Also, women have got pink hearts, right?
[00:08:41.760 --> 00:08:42.000] Right.
[00:08:42.480 --> 00:08:43.440] Men's hearts are blue.
[00:08:43.440 --> 00:08:44.400] Little pink hearts.
[00:08:44.560 --> 00:08:47.200] Women's hearts are like the heart shape.
[00:08:47.280 --> 00:08:48.080] The classic heart shape.
[00:08:48.240 --> 00:08:49.040] The classic heart shape.
[00:08:50.640 --> 00:08:50.800] Yeah.
[00:08:49.480 --> 00:08:53.120] Men's ones that have that kind of more masculine, aggressive kind of shape of a heart.
[00:08:53.280 --> 00:08:56.240] Cinched in the middle, like every female Disney character.
[00:08:57.520 --> 00:09:02.360] And of course, when it comes to some of this, it's exactly your point.
[00:08:59.840 --> 00:09:06.920] Women are disbelieved when they report pain because pain is subjective.
[00:09:07.080 --> 00:09:09.080] Reporting your experience of pain is subjective.
[00:09:09.080 --> 00:09:17.000] Never mind that hearing and writing down a report of pain is also subjective, which we will come to.
[00:09:17.000 --> 00:09:26.680] But definitely this idea that, oh, well, you know, women are misreporting their symptoms and therefore, you know, they're getting dismissed about some experiences.
[00:09:27.000 --> 00:09:32.040] Either dismissed or attributed to something else because, well, women's bodies are weird in it.
[00:09:32.040 --> 00:09:35.320] So if you have got this symptom, it's probably your hormones.
[00:09:35.320 --> 00:09:36.600] It's probably your time of the month.
[00:09:36.600 --> 00:09:38.360] It's probably this, it's probably that.
[00:09:38.360 --> 00:09:43.720] And before you know it, you've kind of you've gone through so many things that you've delayed treatment for a heart attack.
[00:09:43.720 --> 00:09:53.880] And actually, I have a side rant, which is related because I don't think this is as uncommon a thought pattern when it comes to trying to understand and improve the issues with gender bias and other biases as well.
[00:09:53.880 --> 00:09:55.720] You'll have noticed this in the workplace.
[00:09:55.720 --> 00:10:09.960] If you engage with any women in the workplace type initiatives looking at addressing bias, you might see a leadership course that's directed at women in particular or some training on how to ask for a promotion directed at women in particular.
[00:10:09.960 --> 00:10:17.320] As if the reason that women aren't in leadership positions is because they aren't very good leaders and they need teaching how to be trained not to ask properly.
[00:10:18.200 --> 00:10:19.240] They've never learned how to ask.
[00:10:19.320 --> 00:10:22.280] Or the reason they don't get promotions is because they're too timid to ask.
[00:10:23.080 --> 00:10:26.520] I am too timid to ask and I don't get promotions and pay arises as a result of that.
[00:10:26.680 --> 00:10:28.600] You're getting ahead of my point here, right?
[00:10:28.600 --> 00:10:32.920] Because I think when you lay it out like that, it becomes clear that it's bioessentialism at play.
[00:10:33.240 --> 00:10:37.080] Or if we're being really charitable, it's about how women are perceived to be socialized.
[00:10:37.080 --> 00:10:50.800] But ultimately, and this happens for people of colour and women of colour in particular, what we're saying is the reason people are not present in leadership is because there's some fundamental flaw in who they are, and we need to do something to change them, something about who they are.
[00:10:50.800 --> 00:10:52.320] But that's not the issue at all, right?
[00:10:52.320 --> 00:11:01.120] Women aren't worse leaders than men, just people are biased to either not take leadership from women, to not see women as leaders, or to not recognize the wide variety of leadership styles.
[00:11:01.120 --> 00:11:06.560] But similarly, okay, maybe fewer women do ask for promotions than men, but that isn't unique to women.
[00:11:06.560 --> 00:11:10.640] It can also be the case for people new to a certain type of workplace.
[00:11:10.640 --> 00:11:25.360] If you're from a socioeconomic group that doesn't have access to job promotions in the same way as your current workplace, or you're from a particular culture, or you're a first or second generation immigrant, you might not have access to the language or social etiquette rules for asking for promotions.
[00:11:25.360 --> 00:11:27.040] And that's exactly it for you, Marsh, right?
[00:11:27.040 --> 00:11:33.920] That you've grown up in a particular environment that makes you more concerned about the precarity of work.
[00:11:33.920 --> 00:11:34.960] Yeah, I guess so.
[00:11:35.520 --> 00:11:36.880] By which you mean Bishop Auckland.
[00:11:38.800 --> 00:11:45.040] I don't think in the entirety of my parents, but either of my parents' working career, they would have ever asked for a pay rise.
[00:11:45.360 --> 00:11:53.280] I don't think, because I think groups, in certain types of jobs, because I'm not working those jobs, and I have asked for a pay rise.
[00:11:53.280 --> 00:11:57.840] I've just, I find it a much harder thing to do than other people who are like, this is what I deserve.
[00:11:57.840 --> 00:12:07.040] You've never had that modeled to you in the same way as somebody who has had a parent who's worked in a job where asking promotions is part and parcel of working in that field.
[00:12:07.040 --> 00:12:10.720] Yeah, I also don't change jobs anywhere near as often as a lot of other people do.
[00:12:10.720 --> 00:12:18.400] I've worked two jobs basically in my adult life, and even those overlapped for a period of like eight years or ten years.
[00:12:18.400 --> 00:12:20.240] I've never asked for a pay rise either.
[00:12:20.320 --> 00:12:21.840] Never in my life have I asked for a pay rise.
[00:12:22.080 --> 00:12:23.840] Move between jobs and that can normally come like that way.
[00:12:23.920 --> 00:12:25.360] That comes with a bit of a pay bump.
[00:12:25.680 --> 00:12:35.880] It does occasionally, you know, it does come along with a pay bump typically, not always, but it's something I find very challenging to do because I think if I go in and say, I'm worth this, they'll go, no, you're not, you're fine.
[00:12:35.880 --> 00:12:36.680] Yeah, yeah, yeah, I have to do that.
[00:12:36.840 --> 00:12:38.840] And so, and so, okay, well, I just want to answer it.
[00:12:39.400 --> 00:12:40.680] I constantly have the mentality.
[00:12:40.680 --> 00:12:44.120] I've actually been coming up in kind of conversation about having it lately.
[00:12:44.120 --> 00:12:51.320] I constantly have the mentality of if your boss needs to talk to you about something, it's because you're in trouble, it's because something's going to go wrong for any fucking time.
[00:12:52.040 --> 00:12:54.920] A few weeks ago, my boss said to me, Can I have a word with you later?
[00:12:55.560 --> 00:12:56.840] And that was it.
[00:12:57.080 --> 00:13:01.800] I had it with Simon, who I work for, three weeks ago, four weeks ago.
[00:13:01.800 --> 00:13:05.960] He said, Oh, we're getting to a point in the math work that we do where it's quiet over summer.
[00:13:05.960 --> 00:13:08.120] So let's have a chat about your other work.
[00:13:08.520 --> 00:13:10.520] August 18th, is that all right?
[00:13:11.400 --> 00:13:14.360] No, I'm just not going to sleep for a month, actually.
[00:13:14.680 --> 00:13:16.120] That's exactly how I would respond.
[00:13:16.280 --> 00:13:16.680] It's fine.
[00:13:16.840 --> 00:13:17.560] It's just fine.
[00:13:17.560 --> 00:13:18.200] Yeah.
[00:13:18.520 --> 00:13:25.080] On my list of things to write about is why I think imposter syndrome is a myth.
[00:13:25.080 --> 00:13:28.280] Because I think this plays into this same conversation.
[00:13:28.280 --> 00:13:44.840] The idea is that the people who are struggling in particular workplaces are at fault for finding those workplaces difficult rather than the bias and systems in processes in place in those workplaces being the issue that aren't really properly accessible for certain groups of people.
[00:13:44.840 --> 00:13:48.600] And that's why certain groups of people are more vulnerable to feeling like imposters in those places.
[00:13:48.600 --> 00:13:52.680] That's true, although I don't fit into any of those groups of people that you're talking about.
[00:13:52.680 --> 00:13:55.240] I have no marginalization going on.
[00:13:55.240 --> 00:13:58.600] I don't even like, Mike can at least claim neurodivergence against the killer.
[00:13:58.920 --> 00:14:00.200] I don't even have that excuse.
[00:14:00.200 --> 00:14:01.720] I was fucking thrilled when I got that one.
[00:14:01.800 --> 00:14:02.840] He's like, yes.
[00:14:04.520 --> 00:14:05.640] I just am an imposter.
[00:14:05.640 --> 00:14:08.760] That's the only remaining explanation.
[00:14:09.400 --> 00:14:12.320] There's a whole separate conversation about being a jack of all trades.
[00:14:12.200 --> 00:14:17.520] The issue isn't that women don't know how to ask for a promotion.
[00:14:18.080 --> 00:14:24.800] The issue is that the system is set up so that certain types of people are rewarded over others and we only give promotions to people who ask for them.
[00:14:25.440 --> 00:14:27.280] Why is that the way that it is?
[00:14:27.280 --> 00:14:30.320] We don't have to only give promotions to people that ask for them.
[00:14:30.320 --> 00:14:41.200] We could, you know, use personal development reviews to give promotions to people who have made improvements or give, you know, actually be seeking that out for them and not expecting people to ask.
[00:14:41.200 --> 00:14:48.160] Yeah, and obviously the way systems of work are set up in most workplaces is they will pay you what they think they can get away with paying you.
[00:14:48.240 --> 00:14:48.320] Yeah.
[00:14:49.520 --> 00:14:55.360] So the people who go in there say, I am worth this, are more likely to get that than the people who say, well, I'll accept the thing that you think I'm worth.
[00:14:55.360 --> 00:14:58.960] And of course, yeah, the issue is capitalism, but the issue is also biased.
[00:15:00.080 --> 00:15:11.200] And when we're trying to solve it, we're saying, okay, so the problem is this, the reason these groups of people aren't getting access to things in the workplace is because of a flaw with them, not a flaw with the system.
[00:15:11.200 --> 00:15:21.680] So I will go, I've attended women's event groups targeted at supporting women in the workplace that have initiated a conversation with let's teach women how to ask for promotions.
[00:15:21.680 --> 00:15:24.080] It's like, do I have to do yet more learning?
[00:15:24.080 --> 00:15:25.840] Like, I've done women leadership training.
[00:15:25.840 --> 00:15:30.000] Like, fucking men leaders do not have to do leadership training.
[00:15:30.000 --> 00:15:32.480] And half of them are fucking terrible at it.
[00:15:32.480 --> 00:15:36.720] But I have to do leadership training just to prove that I can be a woman and a leader.
[00:15:36.960 --> 00:15:38.000] It's ridiculous.
[00:15:38.000 --> 00:15:40.480] And your leadership training course was called Girl Boss.
[00:15:42.720 --> 00:15:46.960] And this is compounded even further for people of colour, and particularly women of colour.
[00:15:46.960 --> 00:15:54.240] There's loads of specific training for women of colour in the workplace to make them more palatable for the white workplace.
[00:15:54.240 --> 00:15:55.920] It's ridiculous.
[00:15:56.240 --> 00:16:03.160] And I think this is what's kind of at play when it comes to the medical bias here: okay, the flaw is with the women.
[00:15:59.840 --> 00:16:06.120] The reason women are getting misdiagnosed is because of something that's wrong with them.
[00:16:06.280 --> 00:16:09.160] They're atypical somehow, and that's it's their fault.
[00:16:09.160 --> 00:16:11.720] And that is just a fundamental flaw in how we think of things.
[00:16:11.720 --> 00:16:15.960] Yeah, you just haven't learned to ask the doctor for you to not be having a heart attack right now.
[00:16:16.600 --> 00:16:32.600] So, while it is true that medical research is biased towards men or in favor of men, and we sometimes make assumptions based on the experience of entire populations, based on the experiences of just a privileged few, it is not the case that men and women have vastly different symptoms when it comes to heart attacks.
[00:16:32.600 --> 00:16:35.640] So, this is the crux of what I want to talk about today.
[00:16:37.320 --> 00:16:39.080] So, you set us up with a trick question.
[00:16:39.080 --> 00:16:41.080] Is that why do they have different symptoms?
[00:16:41.080 --> 00:16:51.880] But the reason I wanted to set you up with that question was because I think it's one of those things where we've started talking about bias and the issues of bias in the medical world.
[00:16:51.880 --> 00:16:55.320] And same with women talking about workplace initiatives.
[00:16:55.320 --> 00:16:58.680] It's trying to address the problem and identify what the problem is.
[00:16:58.680 --> 00:17:04.360] And so, we come to a conclusion and we get to that conclusion and assume that's the answer.
[00:17:04.360 --> 00:17:10.280] And so, there are lots of skeptics who believe that the reason is that women have different symptoms compared to men.
[00:17:10.280 --> 00:17:11.640] And okay, well, that's just the answer now.
[00:17:11.640 --> 00:17:12.920] So, now we need to address that.
[00:17:13.480 --> 00:17:18.040] There will be listeners listening to this who be like, That's what I always thought, that women have different symptoms.
[00:17:18.040 --> 00:17:29.480] I'm enlightened enough to know that women are treated differently to men, but I've got the furthest I've got is they have different symptoms and not actually applied our critical thinking to that position.
[00:17:29.480 --> 00:17:37.960] And as skeptics, we should be applying critical thinking to all of our positions, even if we think we get to the answer that challenges that bias and then just stop there.
[00:17:37.960 --> 00:17:39.400] That's that's not helpful, right?
[00:17:39.400 --> 00:17:41.400] Yeah, I've been fully add off by that.
[00:17:41.640 --> 00:17:45.360] You are mugged right off, my fucking mugged right off by the position by that.
[00:17:46.960 --> 00:17:50.560] To 20,000 listeners as well, I sound on the right brick now, don't I?
[00:17:50.880 --> 00:17:55.280] But that's the point: is that there will be, and I believed it myself a few years ago.
[00:17:55.280 --> 00:18:02.160] Like, it's a really seductive answer because, well, all of medical research is done in men, we know that.
[00:18:02.160 --> 00:18:09.040] We don't think about the women's experience, and so that's an obvious justification.
[00:18:09.040 --> 00:18:12.640] But actually, have we applied our critical thinking to that position?
[00:18:12.640 --> 00:18:15.840] And, like you say, the heart is the heart.
[00:18:15.840 --> 00:18:17.600] That's only so different it can be.
[00:18:17.760 --> 00:18:22.560] It doesn't matter how obvious an answer it is if the evidence doesn't stack up behind it, right?
[00:18:22.880 --> 00:18:24.240] So, what is the science?
[00:18:24.240 --> 00:18:26.960] So, firstly, we need to understand what a heart attack is.
[00:18:26.960 --> 00:18:29.040] I've been using, I've been throwing a lot of words around.
[00:18:29.040 --> 00:18:32.960] A heart attack medically is known as a myocardial infarction or MI.
[00:18:32.960 --> 00:18:34.240] It's a very specific thing.
[00:18:34.240 --> 00:18:41.360] Well, actually, two very specific things: there's a STEMI or ST elevation myocardial infarction or an N-STEMI.
[00:18:41.760 --> 00:18:47.920] I don't know how medics actually colloquialize that, whether they spell it out every time or not.
[00:18:47.920 --> 00:18:53.360] But I'm going with STEMI and non-STEMI, or non-ST elevation myocardial infarction.
[00:18:53.360 --> 00:19:15.040] So, according to the fourth universal definition of myocardial infarction from 2018, fourth because they renew it every now and then to make sure that it's up to date, the clinical definition of MI denotes the presence of acute myocardial injury detected by abnormal cardiac biomarkers in the setting of evidence of acute myocardial ischemia.
[00:19:15.040 --> 00:19:25.520] So, essentially, the blood flow to the heart has been blocked or restricted somehow, and therefore the heart tissue has become damaged, leading to particular markers to be elevated in the blood.
[00:19:25.520 --> 00:19:35.080] That's distinct from an art attack, which is where Neil Buchanan rocks up at your school and paints a giant mural on the floor in the playground, but makes you watch it from the sky.
[00:19:35.080 --> 00:19:37.560] He makes you watch it from the sky, and they didn't even have drones back there.
[00:19:37.720 --> 00:19:38.440] He didn't.
[00:19:38.440 --> 00:19:42.520] And he leaves paint on the playground, and then that's the playground damage now.
[00:19:42.520 --> 00:19:55.960] Oh no, so the causes can vary, but it's not unusual for the cause to be arthrosclerosis of a blood vessel, which may involve a plaque rupture that causes a blood clot to form and block an artery.
[00:19:55.960 --> 00:19:59.080] But it can be other causes as well.
[00:19:59.400 --> 00:20:06.680] And the symptoms of a heart attack include pain or discomfort in the chest, which arrives reasonably suddenly and lasts for more than 15 minutes.
[00:20:06.680 --> 00:20:11.880] It might feel more like pressure, tightness, or squeezing than pain specifically.
[00:20:12.200 --> 00:20:25.480] You might experience pain which radiates down your arms, particularly the left arm, but it can be both, or pain that travels into your neck, jaw, back, or stomach, or feeling sick, sweaty, light-headed, or short of breath.
[00:20:25.480 --> 00:20:34.920] There is a reason I asked you that question a few weeks ago when you had jaw pain and some other, like left, you were feeling really unwell and you had jaw pain.
[00:20:34.920 --> 00:20:37.880] I was like, Do you also feel sick and short of breath?
[00:20:37.880 --> 00:20:39.160] Yeah, you thought I was having a heart attack.
[00:20:39.160 --> 00:20:39.800] You might have been having an artist.
[00:20:39.880 --> 00:20:41.000] You were having a heart attack.
[00:20:42.120 --> 00:20:42.680] You weren't.
[00:20:42.680 --> 00:20:43.880] I wasn't having a heart attack.
[00:20:43.880 --> 00:20:44.360] Unbelievable.
[00:20:44.600 --> 00:20:47.080] Sudden jaw pain is a reasonably classic.
[00:20:47.480 --> 00:20:48.520] I've just been clenching my jaw.
[00:20:48.520 --> 00:20:49.240] I was stressed.
[00:20:49.240 --> 00:20:49.560] Well, yes.
[00:20:49.800 --> 00:20:50.520] We've had a lot of dress.
[00:20:52.440 --> 00:21:01.160] Is when you have teeth, and I get a lot of jaw pain because I clench my teeth, but that is a common symptom of heart attack, especially if it arrives really suddenly.
[00:21:01.160 --> 00:21:03.160] Especially if you're stressed about having a heart attack.
[00:21:03.160 --> 00:21:08.840] But also, yeah, it's why it can get dismissed as anxiety because, yeah, you suddenly feel sick and short of breath and jaw pain.
[00:21:08.840 --> 00:21:11.560] It's like, okay, well, that could literally be a panic attack.
[00:21:12.520 --> 00:21:19.840] So, if you present with symptoms of a heart attack, the first thing you need is an urgent ECG, which can detect changes in how your heart is beating.
[00:21:19.840 --> 00:21:27.920] And you might also have bloods taken to detect if you have elevated biomarkers, particularly cardiac troponin.
[00:21:28.560 --> 00:21:41.840] A study published in 2019 looking at patient reporter symptoms in 1,941 patients showed that women were more likely to have typical heart attack symptoms than men, 77% compared to 59%.
[00:21:42.160 --> 00:21:45.680] More likely to have typical, as in textbook.
[00:21:45.920 --> 00:21:51.120] Textbook, typical classical symptoms of a heart attack are more common in women than in men.
[00:21:51.120 --> 00:21:54.640] So I'm going to decide that that's because men have exactly the same symptoms.
[00:21:54.640 --> 00:21:59.840] They're just very bad at reporting them because men have to be stoic and not mention anything.
[00:21:59.840 --> 00:22:02.000] But men aren't stoic and just go, no, I'm fine.
[00:22:02.000 --> 00:22:02.640] No, I'm fine.
[00:22:02.640 --> 00:22:03.280] I can put up with it.
[00:22:03.280 --> 00:22:03.600] It's fine.
[00:22:03.600 --> 00:22:04.240] Feed the bands.
[00:22:04.240 --> 00:22:04.720] Force myself.
[00:22:05.040 --> 00:22:12.240] So that might be relevant, but men present at the emergency department with heart attack symptoms more often than women do.
[00:22:12.240 --> 00:22:13.120] Okay, that's interesting.
[00:22:13.120 --> 00:22:22.320] So women are more likely to avoid going to the doctors with heart attack symptoms, but when they do, they're more likely to have your typical heart attack symptoms than men.
[00:22:22.320 --> 00:22:23.840] And to be clear, I was taking the piss.
[00:22:23.840 --> 00:22:24.080] Yeah.
[00:22:25.600 --> 00:22:26.880] I know you two will know this.
[00:22:26.880 --> 00:22:27.760] The listeners might not.
[00:22:27.760 --> 00:22:30.160] They might think, ah, fuck it, but he just looks for fucking bias everywhere.
[00:22:30.160 --> 00:22:32.640] He doesn't have placebo's gone to his fucking head.
[00:22:33.280 --> 00:22:43.440] Furthermore, typical heart attack symptoms in women have greater predictive value for myocardial infarction in women than men.
[00:22:43.440 --> 00:22:55.920] So actually, when women present with three or more typical clinical features of myocardial infarction, the likelihood that they're actually having a heart attack is higher compared to men.
[00:22:56.560 --> 00:23:02.280] And this is not the only study to disagree with the assumption that women have atypical symptom presentation.
[00:23:02.280 --> 00:23:14.200] There are some studies which suggest that women might be more likely to present with heart attack symptoms that don't include chest pain, but that doesn't mean that they're not experiencing classical heart attack symptoms.
[00:23:14.200 --> 00:23:20.360] And it might mean that their descriptions of pain differ rather than being a different physiological experience.
[00:23:20.360 --> 00:23:30.120] So women are more likely to report that their bra is too tight, that they've got a tension under the bra strap area, and it just feels like their bra is too tight.
[00:23:30.360 --> 00:23:32.040] And that's what's causing the discomfort.
[00:23:32.040 --> 00:23:34.760] I mean, women are more likely to report that than men.
[00:23:34.760 --> 00:23:35.160] Yes.
[00:23:35.960 --> 00:23:39.000] Just statistically, I think almost 100% more likely.
[00:23:39.000 --> 00:23:40.600] Not quite, but almost 100% more likely.
[00:23:40.760 --> 00:23:42.840] Well, men famously go out and get the bra properly fitted.
[00:23:43.160 --> 00:23:45.480] Exactly, that's why improperly fitted.
[00:23:46.120 --> 00:24:02.280] So there might be a reason why a woman might misattribute the cause of that pain, but it might also be that a woman might be more likely to describe the kind of tightness or pulling tension pain or discomfort and not quite classify it as pain.
[00:24:02.280 --> 00:24:04.680] You might argue that women have a higher pain threshold than men.
[00:24:04.680 --> 00:24:09.480] They might not get to the point of calling it pain at the same point that men might call it pain.
[00:24:09.480 --> 00:24:11.720] I'm going to get emails about saying that.
[00:24:11.720 --> 00:24:17.960] Yeah, I bet that's also just a reporting bias because it's impossible to, it's harder to really tell what the pain threshold is.
[00:24:17.960 --> 00:24:20.440] Actually, I'm going to start.
[00:24:20.760 --> 00:24:25.240] Speaking of which, we got so many emails from people commenting on our layotrill.
[00:24:25.400 --> 00:24:25.560] Yeah.
[00:24:26.360 --> 00:24:31.320] I think we said a cyanide instead of arsenic and arsenic instead of cyanide, making the same fucking mistake again.
[00:24:31.480 --> 00:24:32.360] I mean, it doesn't matter.
[00:24:32.360 --> 00:24:33.320] It was a throwaway comment.
[00:24:33.640 --> 00:24:36.280] We know if we were making a point, we'd have looked it up.
[00:24:36.280 --> 00:24:37.720] But God, we got so many.
[00:24:37.880 --> 00:24:38.840] I mean, thank you.
[00:24:38.840 --> 00:24:41.080] We do like to be corrected on things when we get it wrong.
[00:24:41.080 --> 00:24:44.200] It's useful, but it was a pure slip of the tongue.
[00:24:45.360 --> 00:24:47.120] Because none of us had that in our notes, right?
[00:24:47.120 --> 00:24:52.640] That was just an off-the-cuff comment in the middle of the show, and we kind of remember the fact.
[00:24:52.640 --> 00:24:53.840] Don't listen to us, listeners.
[00:24:54.240 --> 00:24:55.120] Well, I mean, listen to Alice.
[00:24:55.760 --> 00:24:57.040] Listen to Alice, she's got notes.
[00:24:57.040 --> 00:25:04.000] Listen to the stuff we've obviously written, but take some of the off-hand stuff with a slight pinch of salt.
[00:25:04.000 --> 00:25:15.280] But the study I mentioned before found that actually 93% of women presented with chest pain, they were just also more likely to report a range of the other symptoms associated with a heart attack.
[00:25:15.280 --> 00:25:28.960] So the authors argued the presence of these additional symptoms in women may cloud their symptom presentation, influence clinician interpretation of symptoms, and provide the basis for the atypical symptom message to gain dominance.
[00:25:29.600 --> 00:25:31.600] And this comes to your point about pain, Marsh.
[00:25:31.680 --> 00:25:37.120] We know from all sorts of different studies that women in pain are less likely to be believed about their pain.
[00:25:37.120 --> 00:25:51.600] So if a woman goes to a medical professional and says, I've got a pain in my chest and nausea and palpitations and pain in my jaw, the doctor might respond, okay, nausea and palpitations and jaw pain could be anxiety, completely glossing over the report of chest pain.
[00:25:51.600 --> 00:26:07.040] And when a patient is later diagnosed with a myocardial infarction, her medical notes might not make any mention of the chest pain that she reported to her doctor because they didn't write it down because they were listening for symptoms of anxiety.
[00:26:07.360 --> 00:26:20.480] According to a report from the British Heart Foundation on gender bias in heart attack care, a woman in the UK is 50% more likely than a man to receive an initial wrong diagnosis following a heart attack, according to a study carried out between 2002 and 2013.
[00:26:20.800 --> 00:26:24.160] But there's more to it than just medical bias, too.
[00:26:24.480 --> 00:26:39.640] So, those studies I've mentioned a couple of times showed that women who turn up at the emergency department with symptoms of myocardial infarction experience a delay in being triaged and seeing a medical professional, a delay in medical testing, and a delay in diagnosis.
[00:26:39.640 --> 00:26:45.000] Studies also see a delay in women presenting at the emergency department in the first place.
[00:26:45.320 --> 00:26:51.400] So, one of the issues that the British Heart Foundation raises is an awareness one, both for patients and their doctors.
[00:26:51.400 --> 00:27:01.960] According to them, in the UK, women have roughly half the number of heart attacks as men, but globally, coronary heart disease, the main cause of heart attacks, is still the biggest killer in women.
[00:27:01.960 --> 00:27:05.720] And in the UK, it kills more than twice as many women as breast cancer.
[00:27:05.720 --> 00:27:12.680] Because really common diseases that are less common in one gender than another are still really common in the gender that are less affected because maths.
[00:27:12.680 --> 00:27:18.120] Although, that sounds a very scary statistic, but obviously, part of that is breast cancer doesn't kill that many women.
[00:27:18.200 --> 00:27:22.360] Exactly, breast cancer is normally as legal as it used to be because of the advances of treatment.
[00:27:22.360 --> 00:27:22.760] Yeah.
[00:27:22.760 --> 00:27:27.080] But if you asked me, I'd have said breast cancer kills more women than heart attacks do.
[00:27:27.240 --> 00:27:29.720] Just on, just on off the cough, what do you reckon?
[00:27:29.720 --> 00:27:31.960] Back of the envelope, finger in the air, yada, yada, yada.
[00:27:32.040 --> 00:27:34.120] I'd have said, well, I don't want to imagine breast cancer.
[00:27:34.280 --> 00:27:36.840] I think that's a hyper-awareness issue in the future.
[00:27:37.000 --> 00:27:38.520] I think you're probably the general population.
[00:27:38.520 --> 00:27:42.360] I think you're probably, very aware of breast cancer and way less aware of heart disease.
[00:27:42.680 --> 00:27:47.160] But also, people make the assumption that heart disease affects men more than women.
[00:27:47.160 --> 00:27:51.640] And it does, to some extent, affect men more than women, but it still affects a lot of women.
[00:27:51.640 --> 00:27:55.880] And this comes back to the idea that knowledge and education is based on the experiences of men.
[00:27:55.880 --> 00:28:08.520] Heart disease and heart attacks are often considered to be a man's disease, which means women might be less likely to consider if their symptoms are related to a myocardial infarction and therefore less likely to make their way to the emergency room.
[00:28:08.520 --> 00:28:22.080] Once they see a medical professional, a lack of awareness of the risk factors for women experiencing myocardial infarction can mean the diagnosis isn't on the doctor's radar as an option for that patient and might then delay diagnosis from the doctor.
[00:28:22.400 --> 00:28:26.720] And in fact, some risk factors might even have a greater impact in women than men.
[00:28:26.720 --> 00:28:33.360] One study showed that smoking, diabetes, and high blood pressure have a greater chance of leading to a heart attack in women.
[00:28:33.360 --> 00:28:38.880] They're just maybe less likely to have to smoke and less likely to have high blood pressure.
[00:28:39.520 --> 00:28:50.320] And another reported gender difference is that while women do have similar increases in circulating cardiac troponin when experiencing myocardial infarction, they start with a lower baseline.
[00:28:50.320 --> 00:28:54.960] So that increase can be easier to miss when the thresholds are set against the baseline measured in men.
[00:28:54.960 --> 00:28:55.600] Ah, okay.
[00:28:55.600 --> 00:28:56.640] Yeah, that makes sense.
[00:28:56.640 --> 00:29:03.040] So you're seeing X percent increase in both men and women, but you're starting from a lower point.
[00:29:03.040 --> 00:29:04.640] So the total amount is just smaller.
[00:29:04.640 --> 00:29:05.200] Your threshold.
[00:29:05.760 --> 00:29:11.040] If you've got your threshold set to men, then you don't, you might not even meet that threshold.
[00:29:11.040 --> 00:29:16.160] But if you've not compared it to your individual baseline, because we often don't, this is a problem with medicine just generally.
[00:29:16.160 --> 00:29:24.240] It's the same with various other things is when we're looking for an increase in a particular thing, well, you don't know what the patient's baseline was because you don't usually measure them earlier in their life.
[00:29:24.320 --> 00:29:25.440] I've seen them before they were.
[00:29:25.440 --> 00:29:31.600] So it might be elevated for that individual patient, but we're using population thresholds.
[00:29:31.600 --> 00:29:34.000] I am very much the opposite because I've got a very low pulse.
[00:29:34.000 --> 00:29:35.520] My pulse is obscenely low.
[00:29:35.520 --> 00:29:36.320] Take once a week.
[00:29:36.800 --> 00:29:37.200] Yeah.
[00:29:37.280 --> 00:29:38.160] Something along those lines.
[00:29:38.160 --> 00:29:40.560] No, my pulse typically is below 50.
[00:29:40.560 --> 00:29:43.760] It sometimes gets down as low as 42.
[00:29:44.080 --> 00:29:48.720] The lowest I've recorded it at is 38, which is ridiculous.
[00:29:48.960 --> 00:29:51.200] An average is like 60, 70.
[00:29:51.520 --> 00:29:56.560] And yeah, the average, I think, is like 72, I think, is like the population average for a pulse.
[00:29:56.560 --> 00:30:04.040] But it means every time I get my pulse taken at the doctor's, they comment going, Oh, you're, you know, your pulse is very low.
[00:30:04.040 --> 00:30:04.760] Are you an athlete?
[00:29:59.200 --> 00:30:05.720] And I say, well, no, I'm not.
[00:30:05.720 --> 00:30:09.240] And then the conversation kind of stops because they've got nowhere else to go after that, which is weird.
[00:30:09.240 --> 00:30:12.200] But if my pulse is 60, that's high.
[00:30:12.200 --> 00:30:13.080] Yeah, that's a bad thing.
[00:30:13.080 --> 00:30:16.680] But everyone else, the doctors will look at that and go, well, beautiful normal pulse there.
[00:30:16.680 --> 00:30:17.320] Thank you very much.
[00:30:17.320 --> 00:30:21.720] Because nobody knows that my pulse is fucking 38 or whatever it is, right?
[00:30:22.040 --> 00:30:35.960] Yeah, and it's a really important point that we need to get to grips with better in the medical world because as we start to talk more and more and more about individualized medicine, we also need to think about individualized like human baselines.
[00:30:35.960 --> 00:30:40.200] It comes up with things like testing to see if you're in paramenopause.
[00:30:40.200 --> 00:30:43.880] You don't know what the patient's baseline hormones are.
[00:30:43.880 --> 00:30:54.440] So they might have had low hormones for their entire life and then suddenly, well, it looks like they're in paramenopause, but they've always had low hormones or the other way around, right?
[00:30:54.440 --> 00:30:54.760] That's great.
[00:30:54.840 --> 00:30:59.240] But you've been promising to eventually get around to doing something about the Zoe app.
[00:30:59.240 --> 00:31:02.200] But by the time you get there, you're going to talk to yourself if you think it's a good idea.
[00:31:02.680 --> 00:31:06.440] We just need to get all the baselines on everybody all the time.
[00:31:07.400 --> 00:31:13.080] At the end of this segment, we can talk about my latest device because it's relevant to this topic.
[00:31:13.080 --> 00:31:13.880] The black armband you wear.
[00:31:16.280 --> 00:31:22.120] There are more sensitive forms of troponin testing that can help with this, and we should just be using those as standard.
[00:31:22.120 --> 00:31:26.680] So there are gender differences when it comes to identifying, diagnosing, and treating heart attacks.
[00:31:26.680 --> 00:31:30.920] But it's not as simple as women being different.
[00:31:30.920 --> 00:31:40.360] There are a range of different steps in the pathway that are vulnerable to medical bias, as well as issues with awareness and some biological differences, but not the ones that we think there are.
[00:31:40.360 --> 00:31:42.360] We definitely need to do more research in women.
[00:31:42.360 --> 00:31:50.560] According to the British Heart Foundation, historically, two-thirds of all clinical research has been carried out in men, and women have been underrepresented in cardiovascular clinical trials.
[00:31:50.560 --> 00:31:55.360] And there are fewer women who are cardiologists and all sorts of issues.
[00:31:55.360 --> 00:31:57.760] But two-thirds of medical research has been carried out in men.
[00:31:57.760 --> 00:32:01.280] That is actually, women are less underrepresented than I expected.
[00:32:01.280 --> 00:32:04.160] That means they're in a third, and they should be in about a half.
[00:32:04.160 --> 00:32:07.360] But bear in mind that some clinical research can only be done in women.
[00:32:07.360 --> 00:32:08.000] Yeah, that's fair.
[00:32:08.000 --> 00:32:08.560] That is fair.
[00:32:08.560 --> 00:32:10.480] Well, some can only be done in men.
[00:32:10.800 --> 00:32:13.280] Women very underrepresented in bollock research.
[00:32:13.280 --> 00:32:14.720] Very, very, very underrepresented.
[00:32:14.960 --> 00:32:16.240] Ridiculous.
[00:32:16.560 --> 00:32:22.720] But in the meantime, a realistic awareness of the issue is important in tackling the bias that women experience.
[00:32:26.880 --> 00:32:28.960] So, Alice, you've got an armband on.
[00:32:28.960 --> 00:32:30.000] I have got an armband on.
[00:32:30.080 --> 00:32:31.360] You've had an armband on.
[00:32:31.920 --> 00:32:35.120] For a while, we just thought you'd had some sort of tragedy and didn't want to make it.
[00:32:35.520 --> 00:32:36.080] I'm in mourning.
[00:32:36.080 --> 00:32:36.960] I'm in quite mourning.
[00:32:38.480 --> 00:32:43.280] We know you're not in mourning because we've heard at the start of this episode how you deal with family.
[00:32:43.280 --> 00:32:45.040] It wouldn't be a black arm.
[00:32:45.200 --> 00:32:48.160] Maybe you just joined some sort of fascist troop.
[00:32:48.160 --> 00:32:49.280] Don't say that.
[00:32:49.280 --> 00:32:51.120] I think it's the wrong arm for that.
[00:32:51.440 --> 00:32:56.000] I do have to swap arms occasionally because it gives my skin a bit of a rash.
[00:32:56.080 --> 00:32:57.440] Is there a particular fascist arm?
[00:32:57.680 --> 00:32:58.800] I bet there is.
[00:32:58.800 --> 00:33:00.000] I bet there is.
[00:33:00.000 --> 00:33:02.560] It's like the Nazis always wore it on one arm.
[00:33:02.560 --> 00:33:03.200] Okay.
[00:33:03.200 --> 00:33:08.560] I think if you were a Nati wearing your swastika roundband on the wrong arm, then that would be a four-part at best.
[00:33:08.560 --> 00:33:13.760] I tell you what, for a podcast that we've done just about women in heart attacks, we've mentioned the Holocaust and Nazis a lot.
[00:33:15.920 --> 00:33:17.440] It's just on our minds lately.
[00:33:17.440 --> 00:33:20.800] I wonder why that is, especially when it comes to like health and stuff.
[00:33:20.800 --> 00:33:22.080] So, what's your armband for?
[00:33:22.640 --> 00:33:25.360] My armband is possibly woo.
[00:33:25.360 --> 00:33:26.160] It's not.
[00:33:26.160 --> 00:33:27.160] I don't know that it is woo.
[00:33:27.040 --> 00:33:27.960] Acupressure.
[00:33:28.480 --> 00:33:29.160] It is.
[00:33:28.880 --> 00:33:30.520] It's a heart monitor.
[00:33:29.440 --> 00:33:31.800] It's a continuous heart monitor.
[00:33:32.120 --> 00:33:32.840] That's not where your heart is.
[00:33:33.160 --> 00:33:34.120] So that is woo.
[00:33:29.680 --> 00:33:37.160] You can measure heart rate under the skin.
[00:33:37.320 --> 00:33:40.040] So, like, the best place to wear a heart monitor is around your chest, obviously.
[00:33:40.120 --> 00:33:41.800] Yeah, but then you'll start thinking your bra is too tight.
[00:33:41.880 --> 00:33:43.160] You won't have a heart attack.
[00:33:43.800 --> 00:33:47.960] And then arms are pretty good for detecting with these kinds of monitors.
[00:33:47.960 --> 00:33:54.840] So, chronically ill listeners will have heard of this armband because it's all over social media.
[00:33:54.840 --> 00:33:59.160] And I have been absolutely influenced into buying this thing to some extent.
[00:33:59.480 --> 00:34:03.160] People who don't have chronic illness, when I mention it to them, have never heard of it.
[00:34:03.560 --> 00:34:08.440] This is absolutely targeted marketing for sure.
[00:34:08.760 --> 00:34:18.920] The idea is, and it's connected up to a specific app that is specifically claims to be specifically designed for people with chronic illness and claims to be the only one of its kind, and blah, blah, blah.
[00:34:18.920 --> 00:34:23.320] And that's, I think, there probably is a little bit of sensationalizing in the marketing.
[00:34:23.320 --> 00:34:32.440] But one thing that's important for people with chronic ill health is that the way your body exerts itself is slightly different to the average person.
[00:34:32.440 --> 00:34:33.800] But also, it's different for everybody.
[00:34:33.800 --> 00:34:35.240] Everybody is an individual person.
[00:34:35.240 --> 00:34:39.400] As we've just said, that our baselines differ from person to person.
[00:34:39.400 --> 00:34:49.080] And so, what this is claiming to do is capturing heart rate data continually, unlike a Fitbit which would check in every 10 minutes.
[00:34:49.080 --> 00:34:52.440] In which case, you might miss ten bits of key information.
[00:34:52.840 --> 00:34:57.720] Apple Watch does the same thing, just every so often rather than constantly.
[00:34:57.720 --> 00:35:09.880] Yeah, so this is checking in constantly, 100% of the time, and then it's doing some algorithmic stuff in terms of consolidating my personal data to give me what it thinks is what it calls a pace point budget.
[00:35:09.880 --> 00:35:21.280] So, if you've heard of spoon theory, it's kind of like turning spoon theory into numbers, actually guessing how much energy you have in any given day so that you can try and pace better.
[00:35:21.440 --> 00:35:25.760] The idea of when you have chronic illness, pacing is a key thing that you kind of need to learn.
[00:35:25.760 --> 00:35:37.040] It's something I have learned and do reasonably well with over the years that I've had my various conditions in the idea that you want to, on your very worst days, you want to push a little bit but not overdo it.
[00:35:37.360 --> 00:35:42.480] And on your very best days, you want to do below what you're able to so that eventually you level out.
[00:35:42.480 --> 00:35:49.280] You don't do these peaks and troughs where you keep overdoing it and ending up crashing out and having a terrible few days need to recover.
[00:35:49.280 --> 00:35:53.680] So, it's about monitoring how your body is exerting itself.
[00:35:53.680 --> 00:36:03.840] But what's really useful for me and for a lot of people with chronic illness is how I exert myself on a day-to-day basis changes wildly from day to day.
[00:36:03.840 --> 00:36:08.720] And I don't have any insight into that other than how I am feeling, which is subjective.
[00:36:08.720 --> 00:36:16.560] And I know it's subjective because I'm a sceptic and can talk rationalize myself out of actually giving myself the validation that I need sometimes.
[00:36:16.560 --> 00:36:23.680] So, being able to see that, well, yesterday when I cooked dinner, my heart rate was as if I was at rest.
[00:36:23.680 --> 00:36:27.680] Yeah, and today when I'm cooking dinner, I'm at high exertion level.
[00:36:27.680 --> 00:36:30.240] Sure, my heart rate is beating really fast.
[00:36:30.560 --> 00:36:41.680] I'm therefore using more energy doing basic day-to-day tasks than I am on a good day, and so I can modify my behavior accordingly, but also be a bit more compassionate to myself accordingly.
[00:36:41.680 --> 00:36:48.200] And also, know when I can push when, well, I feel like crap today, but actually, my heart rate's not pushing too much.
[00:36:48.000 --> 00:36:53.920] So, so maybe I can push a little bit further and trust myself that that's not going to push me into a massive crash.
[00:36:54.000 --> 00:36:59.080] The reason I've got it now is not just because I've been completely influenced by social media.
[00:36:59.080 --> 00:37:00.360] Obviously, partly that.
[00:36:59.680 --> 00:37:00.920] Partly that.
[00:36:59.840 --> 00:37:06.360] And I heard about it through social media months and months and months ago, and I've been dismissing it as, oh, it's probably Woo.
[00:37:06.520 --> 00:37:12.360] And then I've had some conversations with people about it, including Kat Ford, who asked me what I thought about it.
[00:37:12.360 --> 00:37:22.280] And I was like, I've not really looked into it yet, and I'm not sure how much I trust it because some of these ideas around how we live with chronic illness is still in its infancy in terms of research.
[00:37:22.280 --> 00:37:32.840] We don't know for sure that the heart rate exertion stuff, although we can see the differences, we don't necessarily know that trying to regulate that will have a long-term positive impact.
[00:37:32.840 --> 00:37:37.320] But I just got to the point where I've had two bouts of burnout this year.
[00:37:37.320 --> 00:37:41.400] I've been flaring up more often than usual.
[00:37:41.400 --> 00:37:47.240] This summer has been absolutely terrible, at least in part because the humidity has been affecting my symptoms so much worse than usual.
[00:37:47.480 --> 00:37:48.040] Indeed, yeah.
[00:37:48.440 --> 00:37:52.840] Partly because the humidity has been worse, but maybe because my body isn't doing as well at the minute.
[00:37:52.840 --> 00:37:56.520] And I just wanted to kind of figure out what's going on.
[00:37:56.520 --> 00:37:59.400] And I thought this was a way to get some of the data that might help me.
[00:37:59.400 --> 00:38:04.040] And I was really wary of it because I don't necessarily think I would recommend this forever.
[00:38:04.040 --> 00:38:06.920] I've only had it for two weeks, so I'm not recommending either way.
[00:38:07.480 --> 00:38:11.080] I don't, I haven't come to a conclusion on whether it's useful or not yet.
[00:38:11.080 --> 00:38:19.400] I'm seeing some value for me personally, but I wouldn't necessarily say that I'm going to get long-term value yet or whether I think it's useful for other people.
[00:38:19.400 --> 00:38:41.120] But one of the risks for a lot of people is having all of this data can increase health anxiety sometimes and can make you do less and then therefore deteriorate more because actually we do need to push beyond, gradually push safely beyond our limits sometimes when we have chronic illness.
[00:38:41.120 --> 00:38:46.640] So I don't think, I think if you have a certain type of psychology, it's probably an absolutely terrible thing.
[00:38:46.640 --> 00:38:47.840] I know my psychology.
[00:38:47.840 --> 00:38:53.200] I've spent years getting to grips with my chronic ill health and using Fitbits on and off.
[00:38:53.200 --> 00:38:56.640] Well, Fitbits, not even on and off, just on for years.
[00:38:56.960 --> 00:38:59.840] And I know how I use that data and information.
[00:38:59.840 --> 00:39:03.920] So I thought it might be useful to help me manage my condition better.
[00:39:03.920 --> 00:39:08.160] But it's all from this idea of everybody is individually different.
[00:39:08.160 --> 00:39:09.280] And this is a piece of data.
[00:39:09.280 --> 00:39:13.120] And actually, I say it's taking all this data, but actually, it's taking two measurements.
[00:39:13.120 --> 00:39:15.120] It's giving me a continual heart rate measurement.
[00:39:15.360 --> 00:40:17.880] And then in the morning, it checks my heart rate variability to and then it sure yeah incorporates some subjective stuff that I input into it but for the most part those are the only two things it's measuring and we'll see if it's useful or not excellent so listeners if you want to get your on bro we've got an offer called we haven't got imagine if we could do an ad for a deck that was how we started doing ads on the show this episode of skeptic sponsored by alice's black armband try alice's black armband i have very specifically not uh named it or endorsed chronic illness listeners will know what i'm talking about and i'm very happy for people to get in touch and ask ask me questions about it if they're thinking about it for themselves or whatever but i'm very much not endorsing it yet i would love if they'd sent it me free because it was it's not cheap it's a subscription model on the app and then you buy the band as well so it's it's it'll work for me with pepsi and a wife so we'll give it a shot why not what i will say is throw ahead to a future show in a in a couple of weeks' time.
[00:40:17.880 --> 00:40:21.240] I'm going to be talking about a device that i'm now showing.
[00:40:21.400 --> 00:40:22.600] It looks very similar to mine.
[00:40:22.760 --> 00:40:27.400] That is a little black box with a black velcro strap that you wear around one of your story.
[00:40:27.560 --> 00:40:28.280] That's fascinating.
[00:40:28.280 --> 00:40:29.000] That is where i'm going.
[00:40:29.000 --> 00:40:31.400] So, you know, come back in a couple of weeks and you hear that.
[00:40:31.640 --> 00:40:33.480] Come back next week and hear my story as well.
[00:40:33.480 --> 00:40:37.800] But then come back the week after and you hear me shit all over the thing that Alice is wearing.
[00:40:37.800 --> 00:40:38.200] No, it's not.
[00:40:38.200 --> 00:40:40.280] It's just a different device.
[00:40:40.280 --> 00:40:42.760] So, yeah, that is what my black armband is.
[00:40:42.760 --> 00:40:50.040] But it's also telling me useful things like when I went to help with your gardening a couple of weeks ago and my heart rate just went, fuck off.
[00:40:50.040 --> 00:40:50.920] What are you doing?
[00:40:50.920 --> 00:40:52.040] Why are you doing so?
[00:40:52.360 --> 00:40:54.440] They take useful things like you overdid it that day.
[00:40:54.760 --> 00:40:58.920] I'm glad you needed a little box that you pay to put on your arm to say that you overdid it that day.
[00:40:59.320 --> 00:41:00.760] The fact that I couldn't move for like a week after that.
[00:41:01.080 --> 00:41:03.560] I was like, I don't think you should be doing it for as long as you are there, Alice.
[00:41:03.560 --> 00:41:04.840] No, it's fine.
[00:41:04.840 --> 00:41:15.480] Well, that was that was my that was quite important therapeutically because, as I say, I've been really struggling with my health recently.
[00:41:15.480 --> 00:41:18.920] And part of that is I overdo things and I'm terrible at not overdoing things.
[00:41:18.920 --> 00:41:23.480] And part of it is that my work is chaotic and I've had to do a lot of traveling recently.
[00:41:23.480 --> 00:41:28.040] And part of it is that I think my body has changed and I've got to get to grips with a change.
[00:41:28.040 --> 00:41:36.120] But it's really difficult psychologically when you have disabilities to adjust to those changes sometimes because it's really fucking frustrating.
[00:41:36.120 --> 00:41:41.080] I've spent years getting things under control and managed to get to a point where I live a relatively normal life.
[00:41:41.080 --> 00:41:44.520] It affects me every single day, but it doesn't have to affect other people in my life.
[00:41:44.520 --> 00:41:48.440] I managed to like deal with that and keep it under control and stuff.
[00:41:48.440 --> 00:41:51.880] And then suddenly something's changed and everything's gone haywire.
[00:41:51.880 --> 00:41:53.800] And frankly, it's not fucking fair.
[00:41:53.800 --> 00:41:54.760] And I really hate it.
[00:41:54.760 --> 00:41:58.440] And I was going through a really emotionally difficult spell with it.
[00:41:58.440 --> 00:42:00.760] And then we went to yours to help do the gardening.
[00:42:00.760 --> 00:42:01.880] And I was like, Fuck this.
[00:42:01.880 --> 00:42:03.480] And I'm getting all this information.
[00:42:03.480 --> 00:42:05.160] And it's telling me I shouldn't do anymore.
[00:42:05.160 --> 00:42:06.440] And it can fuck the fuck off.
[00:42:06.440 --> 00:42:10.200] And I threw a tantrum and I did some gardening, and I paid for it afterwards.
[00:42:10.200 --> 00:42:12.680] But it was really, really cathartic.
[00:42:13.000 --> 00:42:17.840] And I'm glad I did it, even though I paid for it for like a week afterwards.
[00:42:19.440 --> 00:42:33.280] But it was that cathartic nature of it has now allowed me to be like, okay, I've got that on my system, and now I can just be a grown-up and learn how to live with the changes that I'm going through and figure out how to get back onto an even keel and feel positive about that.
[00:42:33.280 --> 00:42:34.560] Because before that, I was just miserable.
[00:42:34.560 --> 00:42:35.760] I was just like, it's not fair.
[00:42:35.760 --> 00:42:36.640] Why do I have to do this?
[00:42:36.640 --> 00:42:38.000] Why do I have to be disabled?
[00:42:38.000 --> 00:42:39.280] Why does it have to affect my job?
[00:42:39.280 --> 00:42:44.480] And the things that I actually want to do or the ways that I show up for other people, that's not fair.
[00:42:44.480 --> 00:42:46.720] I'm just self-pity party.
[00:42:47.360 --> 00:42:48.080] I'm through that now.
[00:42:48.080 --> 00:42:49.920] I've thrown it all at your garden.
[00:42:49.920 --> 00:42:50.640] You did.
[00:42:50.640 --> 00:42:51.440] You did.
[00:42:55.920 --> 00:43:02.320] So, Liverpool Skeptics at the pub this evening, we've got an event going on at the CASA, and that is going to be Kaylene Devlin.
[00:43:02.480 --> 00:43:04.800] Yes, from the BBC's Verify service.
[00:43:04.800 --> 00:43:06.480] We've had some people from the BBC come along.
[00:43:06.800 --> 00:43:18.640] Over the years, we've had a couple of BBC folk, and they're always interesting the insights into the work they do and how they fact-check stuff and how they go about getting to the bottom of misinformation that they're finding in a very politically charged environment.
[00:43:18.640 --> 00:43:20.880] So, I'm sure that'll be a really interesting one as well.
[00:43:20.880 --> 00:43:21.360] Yeah.
[00:43:21.360 --> 00:43:23.440] So, that's going to be in the CASA from eight o'clock.
[00:43:23.440 --> 00:43:26.400] And if you're in the Liverpool area, you should definitely come along to that.
[00:43:26.400 --> 00:43:28.240] We'll be excited to see you.
[00:43:28.240 --> 00:43:32.000] Also, tickets for QED, streaming tickets for QED are still available.
[00:43:32.000 --> 00:43:33.680] You can find those at QEDCon.org.
[00:43:33.680 --> 00:43:37.360] That gives you access to most of the content that we have available.
[00:43:37.360 --> 00:43:41.040] I think the only thing that we don't put on the stream is the workshops because it kind of doesn't fit.
[00:43:41.040 --> 00:43:45.040] Yeah, there may be a couple of speakers who can't stream their work for various reasons.
[00:43:45.040 --> 00:43:46.800] So, we'll announce that ahead of time.
[00:43:46.800 --> 00:43:50.640] But other than that, you'll get absolutely everything-the panels, the podcasts.
[00:43:50.640 --> 00:43:52.720] I don't know if I can stream my talk yet.
[00:43:52.720 --> 00:43:53.440] Yes, you can.
[00:43:53.440 --> 00:43:54.280] I don't know about it.
[00:43:54.160 --> 00:43:54.760] No, you can't.
[00:43:54.880 --> 00:43:55.760] I think I can.
[00:43:55.760 --> 00:43:57.440] I don't know if I can record it.
[00:43:57.440 --> 00:43:58.160] Yes, you can.
[00:43:58.160 --> 00:43:58.840] No.
[00:43:58.480 --> 00:44:05.240] My talk may contain quite libelous stuff.
[00:44:06.120 --> 00:44:09.000] In which case, we should probably replace you with another speaker, mate.
[00:44:09.240 --> 00:44:10.440] In all honesty.
[00:44:10.440 --> 00:44:13.400] I'm going to try not to be libelous.
[00:44:14.600 --> 00:44:20.680] Yeah, so you can find details about that at qdcon.org, where you'll also find we've made a new announcement this week as well, which is good.
[00:44:20.680 --> 00:44:21.960] We've announced two new speakers.
[00:44:21.960 --> 00:44:22.360] We have.
[00:44:22.760 --> 00:44:24.200] Our final two new speakers.
[00:44:24.520 --> 00:44:25.240] Our final.
[00:44:25.880 --> 00:44:26.280] No.
[00:44:26.280 --> 00:44:26.760] No.
[00:44:26.760 --> 00:44:27.880] We've got four more to announce.
[00:44:28.200 --> 00:44:28.760] Four more to announce.
[00:44:28.920 --> 00:44:29.480] We've announced.
[00:44:29.480 --> 00:44:30.360] Two of which we have announced.
[00:44:30.920 --> 00:44:31.720] Should we talk about them now?
[00:44:32.280 --> 00:44:33.400] Should we do them now?
[00:44:33.400 --> 00:44:43.480] So the first speaker that we've got to announce is somebody who came and did a talk for us at Merseyside Skeptics a few months ago, and she was absolutely brilliant, which is why we've got her back for QED and that is Emma McLaughlin.
[00:44:43.480 --> 00:44:58.840] I think we've talked about Emma McLaughlin loads on this show because we first talked about her when Marsha and I went to a festival in the Lake District at Moncaster Castle, which as part of that festival, we went to see the predatory bird show that they do.
[00:44:58.840 --> 00:45:01.000] And it was incredible.
[00:45:01.000 --> 00:45:09.880] And Emma's passion and enthusiasm and knowledge around vultures is just incredible.
[00:45:10.360 --> 00:45:17.560] And I don't know how to get across to listeners how incredible a speaker she is because it's about a topic many, like loads of our listeners will love.
[00:45:17.560 --> 00:45:23.160] Loads of our listeners will love birds of prey, but loads of our listeners will be like, what the fuck have birds of prey got to do with skepticism?
[00:45:23.160 --> 00:45:24.520] And no one cares about vultures.
[00:45:24.520 --> 00:45:26.200] And no one cares about vultures.
[00:45:26.200 --> 00:45:36.920] So it's hard to explain how just amazing she is to watch because that passion is just exudes from her and it makes you passionate about vultures.
[00:45:36.920 --> 00:45:40.920] Like, I love vultures now because she is so great at communicating.
[00:45:41.320 --> 00:45:42.680] At the MSS, we paid to adopt.
[00:45:43.000 --> 00:45:44.560] Our lovely two gay boys.
[00:45:44.200 --> 00:45:48.800] We've got two gay vultures, which we talked about on the show as well.
[00:45:49.520 --> 00:45:52.560] Yeah, because nobody adopts vultures, nobody conservation efforts.
[00:45:52.560 --> 00:45:58.800] People don't put their money towards vultures, they put it towards the pretty, shiny, cute things, and they think vultures erg.
[00:45:58.960 --> 00:45:59.920] But vultures are important.
[00:45:59.920 --> 00:46:02.160] So, yeah, lovely vulture lady.
[00:46:02.160 --> 00:46:04.080] I highly recommend seeing that talk.
[00:46:04.080 --> 00:46:08.000] She's an amazing speaker, and it will be a great, a great session.
[00:46:08.000 --> 00:46:10.240] Yeah, that's going to be an absolutely fantastic time.
[00:46:10.240 --> 00:46:16.240] The other speaker that we've got to announce quite fantastically, because she's doing my panel, is Lucia Osborne Crowley.
[00:46:16.240 --> 00:46:18.080] Yes, we haven't talked about your panel, and we're not going to talk about your panel.
[00:46:18.240 --> 00:46:23.600] We're not going to talk about your panel, but we are going to talk about Lucia, who I'm also really, really excited about.
[00:46:23.600 --> 00:46:32.480] I first came across Lucia when our good friend Robin Ince posted on social media that everybody in the world must read her book.
[00:46:32.480 --> 00:46:37.280] She's written a book about the trial of Gillaine Maxwell, and I would have completely skimmed over that.
[00:46:37.280 --> 00:46:39.920] I would have gone, that's a bit garish.
[00:46:39.920 --> 00:46:42.240] I don't want to, like, it's a bit like rubbernecking.
[00:46:42.240 --> 00:46:44.880] I'm not sure I want to read about this trial.
[00:46:44.880 --> 00:46:49.920] Not necessarily particularly interested in the Epstein stuff generally.
[00:46:49.920 --> 00:46:51.920] Yeah, I would have agreed with you, yeah.
[00:46:51.920 --> 00:46:55.760] But Robin recommended it, and so I was like, and really highly recommended it.
[00:46:55.760 --> 00:46:57.440] So I was like, I'm going to listen to the audiobook.
[00:46:57.440 --> 00:47:01.200] And I listened to the audiobook, and it was an incredible piece of work.
[00:47:01.200 --> 00:47:05.680] She went to that trial every single day, but she's one of the few journalists who was there the whole time.
[00:47:05.840 --> 00:47:10.880] One of the few journalists who was able to be in the room because only six journalists or something were allowed to be in the room.
[00:47:10.880 --> 00:47:13.280] She was in the room every single day, getting up at like 2 a.m.
[00:47:13.360 --> 00:47:16.640] to get there, to get in the queue, to get into the room.
[00:47:16.960 --> 00:47:22.480] But she has this amazing personal experience that she talks about in relation to that story.
[00:47:22.480 --> 00:47:35.160] But also, she's spoken to so many of the victims and built that story around them and really telling it from the impact side of it and talking about the victims at the front and center and why she wants to report it is because of that.
[00:47:35.320 --> 00:47:40.120] It's just she's a great storyteller, but also she's got such compassion for that experience.
[00:47:40.120 --> 00:47:42.440] And it's a really interesting story the way she tells it.
[00:47:42.440 --> 00:47:45.160] Yeah, and I think it's at a very important time.
[00:47:45.160 --> 00:47:47.880] That's why we're so keen to have her at this QED.
[00:47:47.880 --> 00:47:55.160] I mean, I spend a lot of time, I am interested in the Epstein stuff because of the ripple effect it's having through the conspiratorial world.
[00:47:55.160 --> 00:47:56.920] And so I watch a lot of Joe Rogan.
[00:47:56.920 --> 00:47:58.200] Joe Rogan talks about it a lot.
[00:47:58.360 --> 00:47:59.880] The people he talks to talk about it a lot.
[00:47:59.880 --> 00:48:09.000] But whenever they talk about Epstein and even Maxwell, they never talk about the victims ever because the victims don't exist to them.
[00:48:09.000 --> 00:48:13.160] The victims are just pieces in the chess game, but not real people.
[00:48:13.160 --> 00:48:24.440] To the point where Joe Rogan and people like him specifically talk about, well, Epstein was sent down for being a predator and she was sent down for being for trafficking, but trafficking to who?
[00:48:24.440 --> 00:48:25.640] Because there were no clients.
[00:48:25.640 --> 00:48:28.840] So how has she been done for trafficking when she wasn't trafficking them to anyone?
[00:48:29.000 --> 00:48:31.480] Seems pretty clear that there's people missing from this equation.
[00:48:31.480 --> 00:48:34.440] It's like, no, she was trafficking them to him.
[00:48:34.440 --> 00:48:36.360] She was trafficking them for him.
[00:48:36.360 --> 00:48:44.200] You don't care about the story enough because you just see it as this salacious story of like, oh, the intrigue and the conspiracy and all the details.
[00:48:44.200 --> 00:48:45.880] But these are real people.
[00:48:45.880 --> 00:48:47.400] And the real details are out there.
[00:48:47.400 --> 00:48:49.880] If you like, lots of the real details are out there and you don't care.
[00:48:50.600 --> 00:49:00.120] And that's what I'd worried about when, like, well, that's why I maybe wouldn't have read the book before because it is quite mawkish potentially to just listen to a trial about that.
[00:49:00.120 --> 00:49:07.880] But to send to center the victims in it in the way that she did, and very strongly center the victims in it, much more than any story.
[00:49:07.880 --> 00:49:10.440] None of the stories really about Ghillette Maxwell.
[00:49:10.440 --> 00:49:17.680] She kind of flits into the story, but the story is about the victims and the impact that's had on them.
[00:49:14.840 --> 00:49:20.560] But it just really lays out those details.
[00:49:20.800 --> 00:49:35.440] And also, I've found it fascinating learning about how the American trial system works and how those court cases actually play out and stuff and the decisions that were made and how the various barristers have made the decisions that they've made and how they've presented the story.
[00:49:35.440 --> 00:49:37.280] It's absolutely fascinating.
[00:49:37.280 --> 00:49:44.880] Yeah, and we had to have her at this QED because Ghillay Maxwell probably won't be in prison if we ever did another event because she's on her way towards full release.
[00:49:45.200 --> 00:49:49.440] So, yes, if you're coming to QED, you can look forward to seeing those two people on stage.
[00:49:49.680 --> 00:49:51.040] We will also be at QED.
[00:49:51.040 --> 00:49:51.440] We will.
[00:49:51.440 --> 00:49:51.920] I should hope.
[00:49:51.920 --> 00:49:53.440] Last year, we very nearly weren't.
[00:49:53.440 --> 00:49:53.840] Yes.
[00:49:54.160 --> 00:49:57.120] Which was entertaining because we all came down with COVID about a week before we.
[00:49:57.200 --> 00:49:58.160] I did not get COVID.
[00:49:58.160 --> 00:49:59.200] You two got COVID.
[00:50:00.000 --> 00:50:04.800] I probably will again, but we're going to get vaccinated in the month of August.
[00:50:04.800 --> 00:50:06.080] Yeah, very soon.
[00:50:06.080 --> 00:50:06.800] In advance, yeah.
[00:50:06.960 --> 00:50:08.400] Gonna get vaccinated early doors.
[00:50:08.400 --> 00:50:13.200] But yes, if you haven't got a QED ticket, you can buy your online ticket at QDCon.org.
[00:50:13.520 --> 00:50:15.600] Aside from that, then I think that's all we've got time for.
[00:50:15.600 --> 00:50:16.160] I think so.
[00:50:16.160 --> 00:50:18.640] All that remains then is to thank March for coming along today.
[00:50:18.640 --> 00:50:19.120] Cheers.
[00:50:19.120 --> 00:50:20.000] Thank you to Alice.
[00:50:20.000 --> 00:50:20.560] Thank you.
[00:50:20.560 --> 00:50:23.200] We have been Skeptics with a K, and we will see you next time.
[00:50:23.200 --> 00:50:23.840] Bye, no.
[00:50:23.840 --> 00:50:24.640] Bye.
[00:50:29.440 --> 00:50:34.560] Skeptics with a K is produced by Skeptic Media in association with the Merseyside Skeptic Society.
[00:50:34.560 --> 00:50:43.760] For questions or comments, email podcast at skepticswithakay.org and you can find out more about Merseyside Skeptics at merseyside skeptics.org.uk.