Episode 5: Origin Stories: DSM and Dentistry - Transcript

CA: [00:00:00] hi, Teamsters I'm Carey Ann

AE: [00:00:17] and I'm Allison.

And this is podcast without an audience

CA: [00:00:20] where two friends pick two topics and find that intersectionality or not. Um, so far

I think the intersectionality piece has been my favorite part of this. Yes. We're trying something

new today.

AE: [00:00:34] We are. We're going to be, uh, more organized, I think, which is it's only taken

us.

How many episodes you get here? Six or seven. It's unclear at this time. Um, we're going to be

drawing the Venn diagrams. I will have already included my portion. You will maybe have

already included yours. And then we're going to be keeping track of how things intersect so that

we can give a more comprehensive possibly somehow intersectionality

CA: [00:01:02] analyses though.

I do hope that, um, you will appreciate all the work that went into doing this just in our heads

only now, have we decided that we need to actually write shit down?

AE: [00:01:13] Well, I've also had people recently be like, Oh, your cover are it's a Venn

diagram.

CA: [00:01:20] Thank you. Shout out to actual angel Ashley Acevedo.

AE: [00:01:24] Right? Um, And Zach Smith too. Who helped come up with that? That concept?

CA: [00:01:30] Yep. Yep. We've got good people.

AE: [00:01:33] We've got a good team. We do. I love everybody. Um, yeah, so what's going on?

How are you?

CA: [00:01:39] I am great. I love being here with you and your new little puppy finally asleep.

AE: [00:01:46] God, it's like having a tiny, hairy baby,

CA: [00:01:50] a little infant, if you will.

AE: [00:01:53] So French Bulldogs make such unique noises. Um, I'm wondering if the mic is

going to pick up any of them, but we are recording in, um, my bedroom today, hoping that we

can get some better sound quality, um, with all of the fabric and he's on his little bed. He's got

his Yoda. Toy. And hopefully he will stay asleep.

It's very star Wars, very star was Obi wan Kenobi.

Um, but he's so cute. And um, I just want to pick him up and squeeze him like so hard. And you

said something super relatable a minute ago, what'd you say? I want to squeeze him until he

cries and then I want to make him feel better.

CA: [00:02:41] I love that this is like an actual studied psychological phenomenon where people

want to bite. Like, have you ever had the feeling of. Like just wanting to squeeze someone so

hard or bite someone, the biting because you love them.

AE: [00:02:57] The biting. Yeah. I know exactly what you mean with the biting. Like if for, um,

the cat people, the ear nibble is, is

people who don't have cats are probably like, Hmm. But it's probably the same. Do you ever get

the urge to like bite the paw like not bite, but like,

CA: [00:03:18] have you seen the Leo's toe beans? He has the cutest little feet. Yes. Of any

creature I've ever seen

AE: [00:03:25] beans. Toe beans. Yes. I love that. That's so that's an actual, it's

CA: [00:03:30] an actual psychological phenomenon and they don't really know why people do it

other than like, you just have all of these happy chemicals, so much floating around in your

brain and your is like, we have to get rid of them somehow.

Right.

AE: [00:03:44] My mom says, I love you so much, like a big stack of pancakes. And she also

says like, I love you. Like, my heart is overflowing. It's just like sloshing over. So those are like,

Yeah. I, I, I definitely big stack, big stack. That's cute. I love that. I say it all the time.

CA: [00:04:05] When we were growing up, my, um, my mom would like, hold our hands in the

car or something.

And she would squeeze us really hard three times. Oh. And then we would squeeze her back

twice and then she would squeeze us back really hard. One time and shake. And the three was,

I love you and the two was how much. And then the last squeeze was how much she loved us.

Adorable. I know. We're pretty stinking.

AE: [00:04:30] Awesome. Are you guys,

CA: [00:04:31] we still do this sometimes too.

AE: [00:04:34] We did a walkie walkie skip where like my mom and dad would hold our arms

and then swing us up. Aw. That was the thing. And then they time us quote, unquote time us

running around the house. Yeah. I see your mom and dad. I know you were not timing.

CA: [00:04:49] They were counting if at best.

Yeah.

AE: [00:04:52] Well, my sister, um, Is pregnant. And I FaceTimed with her the other day and

literally, so my parents are down there and I was like, show me, like, show me your belly. And

so she like, yeah, like what's going on? And, and, um, she, she had a dress on and she like

brought the, the fabric, like close to her. I could see her little baby bump and I just started crying

so much.

She's just growing a human. She could do nothing all day and still be more productive than that.

Any of us

CA: [00:05:23] today, she's working on an eyeball tomorrow. There'll be a

AE: [00:05:26] face. It's kind of like a puzzle yeah. Situation. I'm pretty sure. Yep. Um, you got

your Venn diagram. Ready, girl. You ready

CA: [00:05:34] to, I'm getting there this week.

I am covering the history of mental health and the diagnostic and statistical manual or the DSM,

the DSM.

AE: [00:05:44] Are you familiar with the dinosaur sub marinara, right? Correct.

CA: [00:05:49] Yes. Perfect. Dyno nuggies um, So in our very first episode, we talked about the

history of mania, which. I mean, we called it the wandering womb because that's really where it

originated in ancient Greece.

Ultimately it was the, the history of mania. So, um, we're going to jump ahead to last year. Oh,

the 2020 census. Do you remember completing, did you complete the census? I did get on my

dolls and yeah,

AE: [00:06:18] yes. Yeah. Everybody was super, which is good. It's it's an obligation. We

almost. Do and it helps. Yeah.

CA: [00:06:26] It helps with like funding and, you know, figuring out needs, except that it's so

flawed.

Um, and it changes every year. Um, I know that, um, so we just completed the 20, 20 census

and I remember there being a lot of discussion about what questions should be included

specifically. I know that there were issues brought up around race and ethnicity for at least the

past couple of censuses. And then this time they really talked about gender identity and sexual

orientation.

Like what questions to ask, how do you navigate finding information on that? I think in the 2010

census, I remember there being a question about sexual orientation. I could be wrong. Is

AE: [00:07:08] it in relation to marital status or maybe

CA: [00:07:11] I don't actually remember, however, an 1840, the big question was. Quote, how

many people in your family are deaf, dumb, blind idiots or insane?

Oh no. It's the first year that they asked about disability and mental health. Um, and there were

no definitions assigned to these turn. Right? Like they were just like, uh, could you self-disclose

sure. It's and of course men were the people answering these questions. Like it was head of

household answering the questions.

So in sane could refer to like any unusual behavior. Um, idiotic could be like a learning disability

or anything else. It was super vague and probably done that way on purpose. Um, I know me

too. So what I'm imagining is like a smart ass CIS man, making a joke about everyone in his

family being an idiot or insane, right.

Because you know, like people are out there who say

AE: [00:08:15] shit like that. My thought goes to like, was it well intentioned asking these

questions? Or was it that they were just problematic?

CA: [00:08:26] A great question. The intent was to figure out where money needed to go to

build asylums. Um, and mental health services.

And we'll talk about that in just a second, but it was super, super problematic. There was also

another hidden reason which we'll get to in just a second as well. Just a quick preface.

Obviously we don't use this language anymore around mental health or disability, but the

rationale was that the government was interested in creating systems to benefit people with

disabilities.

Okay. For about a hundred years after the census, there was a period of asylum building. Um,

like I'm thinking American horror story asylum, like lock

AE: [00:09:03] up the lesbians. We hear a lot about them from a certain time period.

CA: [00:09:07] Yeah. Yeah. And did you ever read one flew over the Cuckoo's nest?

AE: [00:09:12] Um, no, I never did

CA: [00:09:13] mercy.

The movie Jack Nicholson, um, such a good movie and I love the. Idea that like the person who

was in the institution was actually saying while everyone around him was not. Yeah, my

AE: [00:09:27] like, from like a cinematic perspective, I think of shutter Island, right. In the, the

thought process of, um, the doctors and nurses being really adamant about, uh, helping, um,

These patients instead of, you know, which was kind of revolutionary concept, it

CA: [00:09:46] was.

And from what I read, like a lot of these asylums weren't actually horrible places. I mean, many

of them certainly were like, they were not looking at people holistically or trying to actually help

them get better. It was a way to institutionalize them and get people out of society. But in some

of them, like there were positive outcomes.

Like people really genuinely wanted to help people heal. It probably

AE: [00:10:12] depends on too how much you can afford because the, you know, the more

money you spend the better.

CA: [00:10:18] Yeah. Yeah. Um, but we'll talk more about the silence. Cause I think I want to do

like a special topic on justice items. So stay tuned because it's a fascinating topic.

The census essentially would demonstrate a need for institutionalized care and that was. The

idea, um, later in like the 19 hundreds, it was less about helping people and more about

preventing them from reproducing. Oh, wow. So small aside here and we'll come back to this

tale, but eugenics was really popular in the early 20th century.

Um, and forced sterilization continued all the way up into the 1980s in the U S um, and I just

can't do eugenics justice on top of the history of mental health and the DSM. Yep. So these are

all gonna have to be separate subjects. However, I can't not mention it in this episode. What I

do want to say is there a still active systems of oppression in the U S that are structured to

prevent disabled people from marrying, for example, a disabled person who's receiving SSI?

Um, not to be confused with SSD, I cannot have more than $2,000 in assets in their bank

account and still receive services and support. Through SSI. If they're married, that number is

only 3000. So regardless of if the person they're marrying is disabled or not, Oh wow. They can

not have more than $3,000 in their bank account, no savings.

They can have a house in one car. Wow. And that is all that they are allowed according to. SSI

to qualify. Yeah. Yeah. And if you, at any point make more than that, you're removed from SSI.

And then it's like a two to six month period before you can get it back. So SSI is supplemental

security income and SSD is social security, disability insurance.

So that's the difference between the two, one is a supplemental money that's coming in each

month to help you meet your basic needs. And the other one is social security for disability. So

both work with people who are disabled. So, but it's just one way that people are continuing to

police disabled bodies and not allow them to, you know, accrue any kind of wealth or status or

anything because in order to receive some services and benefits, you have to be eligible for

supplemental.

Security income. It basically means that disabled people are forced to stay in poverty. We also

can't have this discussion without talking about race. So history.com says in particular, the 1840

census was shown to have severely over counted the number of free black people who were

insane or idiots as reported.

Okay. This is data that supporters of slavery may have used as propaganda to argue that black

Americans were not able to handle freedom. Oh my God. I hate the way that that's worded hate

that this is part of our history and that no one talks about it. Yeah, because I mean, there's still

so much stigma, especially in black and Brown communities around mental health and mental

health services.

Since because things like this have been used against them, you know, since even before the

1840s. So this is interesting to me and. Our first bold graphic that we put out for the show.

You're said, don't make me repeat myself. You remember your bust and, um, which I love

because it sassy and cute, but also history is constantly repeating itself.

And that's the way that black and Brown and disabled Americans are still treated in the U S like,

they're still treated as though you have mental health issues or not. Um, but we are going to

discriminate against you based on the assumption that you can't handle X, Y a lot of assuming.

Yeah. Um, we can directly trace over counting free black people and mental health to later

diagnosing them as incompetent.

Um, we can trace it to mass incarceration because of our system of support, those built directly

on the fallacy that black Americans are unable to handle freedom. And that disabled Americans

don't deserve the right to access, support, resources, and marriage, or a family. Uh, like this just

goes so deep.

AE: [00:14:27] Wow.

Yes, it does.

CA: [00:14:30] Yeah. So this census about 17 million people were counted. And this sounds like

a small number. Um, but 17,456 were listed as insane or idiots. However, experts have said that

because of the over-reporting and black communities and black and Brown communities and

under-reporting and white communities, this is actually worthless data and it's super objective

and objectifying, right?

So it means nothing.

AE: [00:14:58] It reminds me of when you're going to do a case study, you have to make sure

that you're the, the population that you're that's involved in the study is diverse with in many

aspects. So yeah, that makes a lot of sense.

CA: [00:15:10] Now there are some mixed accounts of what happens next. So we've got

another census, another few censuses coming up.

And at this point

AE: [00:15:18] where they're doing them every 10 years.

CA: [00:15:19] Yeah. So according to psychiatry.org, um, by the 1880 census seven categories

of mental health were distinguished. Okay. Mania, melancholia, Monomania, paresis, dementia,

disomania, and epilepsy. However, according to history.com, um, in 1980, it States that the

words were just is someone in your household defective of mind and

AE: [00:15:46] in 1880 or 1980

CA: [00:15:48] 1880.

Okay. So 1880 was. Um, there may have been seven categories in 1890. The words defective

of mind were getting to be used. Gotcha. Okay. Um, and I actually looked this up to see what

the censuses said, and they're just so problematic. Um, but instead of reading them to you, I'm

going to post them in our pictures for the notes from last week, because they're worded

differently based on your race too.

They were what they were worded differently based on your race. I know. Oh, I hate this. I hate

it so much. They also use words like crippled, maimed and deformed. As options to categorize

people in your home,

AE: [00:16:29] the, um, did you notice any language around

CA: [00:16:32] gender? Um, it was just male or female. Okay. Yeah. Um, the male or the head

of household was almost always male.

And then you had to click male or female or check male or female. Um, often put names and

then like how old they were when the census was taken.

AE: [00:16:48] And do you know anything about the distribution of the census? About how it

was actually,

CA: [00:16:53] it was done door to door, door to door, kind of like they did for you in 2020,

because she didn't do it online.

AE: [00:17:00] Listen, I was visiting him, having a mental breakdown.

CA: [00:17:05] We all were. No, it's so funny when the 2020 census came out, I was staying in

Pittsboro and Oh yeah, like when I completed it. So, um, But my apartment was technically still

Greensboro. I think my mom like counted me in Pittsboro, even though I didn't live there.

So there may be two of me for this year or for these 10 years

AE: [00:17:27] voter fraud, CA

CA: [00:17:30] um, and for anyone who's listening, that's totally false. We're not being recorded

right now. Oh, something else that's really interesting to note is in the 19, or I'm sorry, 1890

census. Um, there was a question about whether a person was a prisoner convict, homeless

child, or popper as part of your family, a popper.

Yeah. Huh. Also homeless child, like, well, homeless adults, homeless people, no homeless

child, child or

AE: [00:18:02] popper. So pauper is the of age version of the homeless,

CA: [00:18:07] I guess. Uh, again, their definitions were given. It was just

AE: [00:18:11] not, and it's also not people experiencing homelessness. Right?

CA: [00:18:15] Right. Gotcha. Yeah. Okay. So back to the DSM, uh, because that's actually our

topic, not all the shitty things that the census, but the census ties directly into the DSM.

So we're pre world war II in 1917, the American Medico psychological association, which is later

the, um, APA, the American psychological association and the national commission on mental

hygiene was developed. Um, and they made a plan to bring these statistics from mental

hospitals rather than through the census, which is why we don't have questions about mental

health on the census today is because these two organizations were developed and they were

like gathering this information through the census and people, self reporting isn't accurate.

We need real data, actual data. So they started going to, um, mental hospitals to get that

information. We

AE: [00:19:11] imagined that the healthcare industry has a much better record keeping system.

CA: [00:19:15] I mean, theoretically, but like. There was also this practice of just declaring

people insane or incompetent or,

AE: [00:19:23] or the opposite too.

I mean, or yeah, like, you know, absolutely necessarily count on everyone to, to be honest or to

diagnose there's, there's a lot of things that are going on and diagnosed, so, Oh, absolutely. I

understand

CA: [00:19:38] your point. It later developed a nationally acceptable psychiatric classification

that would be incorporated with the first edition of the American medical association, standard

classification, nomenclature of disease, which is a long ass name.

And we got an acronym. We do not there is no

AE: [00:19:59] acronym in the whole thing.

CA: [00:20:02] Um, and this was used for diagnosing patients with severe psychiatric and

neurological disorders. So it's like the precursor to the DSM. Right. Got it. Essentially what

happened is we just kind of went out and started counting people to get money to fund

hospitals.

And then the hospital started self-reporting data and statistics, and then the APA stepped up

and created a standard for diagnosing. And I see no problems here. What could possibly go

wrong? That's a lot of breaks in the kitchen. Yeah. So world war II happened and then the U S

army gets involved and they decide that they need a broader classification system so that they

could support servicemen and veterans, which I guess is like a positive outcome of sure work

too.

AE: [00:20:42] This is after world war II.

CA: [00:20:43] Yeah. So this is like the 1940s and early fifties. Okay. So at this point after, yeah.

Uh, so by this point, the world health organization was already on it and have published their six

edition of the ICD and the ICD stands for the international statistical classification of diseases

and related health problems.

So it was not just for mental health issues. It was really for like this whole spectrum of stuff. But

in like the 1950s, they'd publish their six ICD, uh, we're currently on ICD 11. Oh, okay. Yep. Just

in case you want to go look it up. The sixth edition was the first time that it had a section for

mental disorders and included 10 categories of psychosis, psycho neuroses, and seven

categories for disorders of character, behavior, and intelligence.

Now America is certainly not about to be out done by the world health organization. So the APA

committee was developed and started to write the first ESM. Okay. Um, in 1952, it came out

and the DSM, um, against the diagnostic and statistical manual of mental disorders. And it was

basically at that point, a glossary of diagnostic categories, like a dictionary.

Um, the second edition was published in 1968. And with super similar jumping ahead, the DSM

three was, uh, published in 1980 and there were a number of changes, including explicit

diagnostic criteria. So this is the first time that we have not just like a dictionary that we can go

to and say, what is bipolar disorder, but then actual tool that we can use.

To diagnose somebody, the DSM three also created five axis to talk about people. And the idea

was that this would be a really holistic way of looking at humans who had things going on. Okay.

So axis one was a clinical syndrome. Axis two was a lifelong disorder or handicap access.

Three was a physical condition.

Access four was the severity of the psychological stressors and access five was your highest

level of social and occupational functioning in the past year. So it was a quick read through of

the top five things that could be going wrong if you're having a mental or physical issue. Okay.

Um, and by and large, this actually may have been a good thing.

There was a decreasing in diagnoses, especially an accurate diagnosing and it was more

unified and provided an opportunity to communicate more clearly.

AE: [00:23:20] Yeah. So overall like a reference. Yeah,

CA: [00:23:23] it was not the worst thing. The DSM three R or three revise and the DSM four,

the DSMR came out like just seven years after the first DSM-III and there were no fundamental

changes, but pretty substantial minor ones.

Like sleep disorders were expanded. Some categories were dropped, others were added and

there was a slight change to the access system, which I actually really appreciate and was used

until like 10 years ago. And even now, like if I'm working with older mental health workers or

social workers, they still reference these axes.

AE: [00:23:59] No, it reminds me of, um, an episode three, when we talk about, um, the chakras

and preventable tragedies and just kind of like revisiting topics, which is like extremely healthy

to be monitoring and always evolving and changing.

CA: [00:24:15] Um, so axis one. At this point is now clinical disorders like substance use.

Uh, this is where gender and sexual identity disorders is still very present in the, as a mental

health issue. Oh God. Yeah. And also, yeah, me too. Like, I mean, gender dysphoria is still in

the DSM-V isn't this is an actual thing that people experience. It's not something that this person

just made up. So for

AE: [00:24:46] me, that sounds like it's in a negative light.

So that's where I have that an issue of that maybe you can touch more on that.

CA: [00:24:56] I think what's really interesting about it is like, um, inherently gender identity and

sexual orientation are not negative. Like we know that, you know, you can be trans non-binary,

lesbian, queer, gay, whatever, and that doesn't diminish your quality of life, right.

Something that might diminish your quality of life is having gender dysphoria and not being able

to seek treatment for it. Okay.

AE: [00:25:24] I see what you're saying. I guess my, my point, I think I might have an issue with

it being a diagnosis, as opposed to somebody just. Being trans well, and I, from a point of, of the

stigma of you're being diagnosed, something is wrong with you.

CA: [00:25:40] Transgender refers to a person whose sex assigned at birth does not match their

gender identity. Right? We know all that. Some people who are transgender will experience

gender dysphoria, which refers to a psychological distress, that results from an incongruence

between one's sex assigned at birth. And once gender identity, though, gender dysphoria often

begins in childhood.

Some people may not experience it until puberty or even much later, but not all people

experience gender dysphoria. So people who are trans may pursue multiple domains of gender

affirmation, including social affirmation, legal affirmation, um, medical affirmation and or surgical

affirmation of note, not all people who are trans.

Well desire, all domains of gender affirmation. These are highly personal and individual

decisions, and this is directly from psychiatry.org, but it's super important to just note that

gender identity is also different from gender expression and gender identity is what's going on in

your brain and expression is what's going on outside of your body.

Like what you put on your body. Um, so you can have like a feminine gender expression or

more masculine, like historically masculine talk

AE: [00:26:58] about Eddie Izzard. And, um, he, uh, from what I know uses he him pronouns.

And, um, he has a quote that says, it's like, people ask me why I'm wearing women's clothes.

And he says, they're not women's they're mine.

I buy them. I love that. That's great. Yeah.

CA: [00:27:16] Yeah. And because, I mean, I hate that clothing is gendered. As it is, but one of

the benefits to having this in the DSM-V is often trans people may pursue therapy options. And

if they don't have a coexisting mental health issue, then it's hard to get insurance.

Gotcha. Understanding more now. Yeah. You have to have something to tell the insurance

company why you need therapy. So I think that that's one of the good things that comes out of

it. I don't like the stigma around, well, it's in the DSM and therefore it's wrong. But the turmoil

that wen experiences is very different than the joy that one might feel for being trans.

So, and also different than body dysmorphia. Oh yeah, though. I think they CA can be co

morbidities, right? Like you can, that might be the topic for

AE: [00:28:12] my, you drive the strain. I don't know enough about it to

CA: [00:28:16] speak on it. Yeah. Getting back to our DSM three R. Um, there was a slight

change to the axis system that was established.

So axis one is still clinical disorders could include delirium, substance use, gender and sexual

identity disorders, eating disorders and sleep disorders. Again, remember this is like the

eighties. What a time. Yeah.

AE: [00:28:37] So rocking and rolling and whatnot.

CA: [00:28:39] Also going to do some research on this after our conversation today.

Cause I haven't put this much thought into it before and I want to make sure that I'm listening to

trans voices as I'm talking about this because I am a privileged CIS person who, um, has had

the great privilege of not having to really think about this before. So I wanted to make sure that.

I'm not saying something that's anti ally.

Absolutely. Yeah. Um, access to his personality disorders, including like paranoid personality

disorder, antisocial, borderline narcissistic avoidant. So on, so forth. Um, access three is

general medical disorders like, uh, cancer, which could be causing you to feel depressed. So

looking at how all of these intersect and overlap access for is psychosocial, environmental

factors.

Like, do you have problems within your support system? A social environment, educational,

occupational housing, economic access to services, access five is global assessment of

functioning and it's on a scale of zero to 100. And it's basically like, how is the person doing

over? Hmm. Okay. Yeah.

AE: [00:29:48] Can you explain that?

How that w the accesses and how that. Yeah. So what does that mean?

CA: [00:29:55] Sure. So for example, um, say someone has. But the way that they really do it is

they write it out. They say, axis one clinical disorder, um, so you have a substance use disorder.

Okay. Axis two is borderline personality disorder. Like it's, uh, associate with a personality

disorder.

Um, you may not have a medical issue that relates to either of those or at all. Um, so you axis

three does not apply access for psychosocial environmental factors. Like, uh, maybe you don't

have a support system, which is helping you deal with your borderline personality disorder,

which is contributing to your substance use.

Does that make sense? So it's kind of a way of just looking at people and saying, what are

some of the big five things that might be contributing to their dissatisfaction or. An ability to feel,

you know, satisfied with their lives.

AE: [00:30:51] So you could have one and two and skip three in. Yeah.

CA: [00:30:57] Okay. Yeah. Or you could skip one and two, but have Lyme's disease for axis

three.

Um, and then skip four, but you still have some kind of something going on in your body. That's

gotcha. Yeah. Gotcha. Gotcha. Yep. Yep. Okay. So the DSM-IV was published in 1994 and this

one was actually based on research and comprehensive study.

AE: [00:31:22] Crazy concept

CA: [00:31:23] It only took us 150 years

AE: [00:31:27] crazy ideas.

CA: [00:31:28] I know why there wasn't any research done before this, but it's just mind blowing

to me that when I was three years old is when this book came out.

And it's the only one that was truly established on research. Yup.

That's

AE: [00:31:40] fucked up. Yeah. That's all. It is. Anything that just happened in the nineties

should scare us all.

CA: [00:31:47] Exactly. Yeah. An interesting thing to note around this time is there may have

been a typo that broadens the criteria for the diagnosis of autism.

Was it a comma. It was not what was that? It was the switch between the word and, and the

word or for meeting criteria. Oh, so,

AE: [00:32:06] okay. That'll do it.

CA: [00:32:08] Yeah. It just, you know, rather than having symptoms contingent upon each

other, it

AE: [00:32:14] completely re so the word it reads or

CA: [00:32:18] rather than and,

which is whyin the nineties, you saw this huge increase in people being diagnosed with autism.

And it's because suddenly the DSM was like, yeah, you can be diagnosed with autism. If you

have any of these or any of these. Okay. Versus previously it was this. And this. Okay. Really. I

think that more research needs to be done. And there's a great book called NeuroTribes by

Steven Silverman. Okay. Um, that's about the history of autism and I highly recommend, I think

I'm going to do a book club episode on it at one point.

Oh, I love at some point, basically the argument is that people were associating the rise in

autism with vaccines, or, you know, we're just too Willy nilly about diagnosing people with things

now. And really the criteria that was used is what changed. Um, and in a lot of cases, I think it

helps people get access to services.

Sure. Um, even though. Are there still people who are inappropriately diagnosed with autism

when something else is actually going on? Absolutely. So we're almost at the end here, the

DSM-V appeared in 2011. It did away with the axis systems, although working in child welfare,

like I said earlier, sometimes they still come up.

Um, just because so many people have used it for so long. Um, I mean, it was around for like 16

years. So some of the major changes in the DSM-V included, changing the term mental

retardation to intellectual developmental disorder or intellectual disability. Uh, the diagnosis of

Asperger's has been removed and is now high functioning autism or HFA. ADD has been

removed and is now under ADHD with the differentiation between, um, being inattentive.

Hyperactive or combined type.

AE: [00:34:06] Interesting. I didn't know that one. Yeah.

CA: [00:34:07] So, um, now what was previously thought of as being add is actually inattentive.

ADHD. Okay. So you don't have the hyperactivity portion to it. There was also information

added about ADHD across a lifespan. Like previously it was an issue for kids because they

couldn't focus in schools, which is a whole other thing.

Um, and now we know that it's actually a specific way that the brain is wired. That's just

neurodiverse, but there were lots of other changes as they relate to like schizophrenia,

depressive disorders, bipolar related disorders, anxiety, OCD, Lots of changes in the DSM-V

one thing I really do appreciate.

And I think going back to your comment earlier about our third episode is the more we learn, the

more we are adapting and like constantly circuit circling back. So going forward in this podcast,

I'll probably start picking some specific diagnoses and doing like a little bit of a deeper dive into

their history, like the application of a diagnosis.

Um, but I just didn't feel like I could really do that until we talked about the history of mental

health. Yeah. So like how did the 1840s and the questions on the census impact the

development of the DSM or the language

AE: [00:35:23] that was used, and even, even me, even here with you understanding certain

concepts and just making sure that we are establishing our opinions and thoughts and as

opposed to.

You know what the language being used now, because I'm sure that things that we say now, or

that is considered current will be outdated. And. Yeah, problematic in the future. Right?

CA: [00:35:52] Absolutely. And I think that, that's why, like, I'm okay with saying, this is how I

understand it now, but let me do more research.

Right? Absolutely. And I think that that's something we're both really good at. I think so too. Um,

mentally health services. Oh, one of the other things I really wanted to point out is how mental

health diagnoses have been used to suppress and really control people. Um, and how they're

still highly stigmatized in many communities and access to affordable mental health services are

difficult to navigate.

Um, I mean, for me, I'm fortunate enough to have the insurance time and accessibility during a

pandemic to see a therapist, but I'm lucky as hell. Like I know so many people who aren't and

not just for the reasons we just mentioned, but also historical cultural issues, but that's a brief

synopsis of mental illness in the DSM.

AE: [00:36:42] Wow. That's a heavy one.

CA: [00:36:44] Yeah. Yeah, we've done a few light fun ones recently. So I figured this would be

a good switch up

AE: [00:36:49] for ya, but also important

CA: [00:36:50] to it is. And, um, I was feeling really reflective about some mental health stuff

recently. So it was a good kind of deep dive into how we got to where

AE: [00:37:00] we are.

Yep. I think, um, you know, discussing mental health, discussing physical health. Yeah. Um, you

know, even back to episode three, like I mentioned earlier, um, internal check-ins I guess

maybe yeah. Um, is really important, especially, you know, we've all lived a very crazy year.

Yeah. Oh, absolutely. Um, it's really important to be discussing these things, especially now.

Right. I agree. My topics a little more light-hearted although it would be disturbing to some Oh,

CA: [00:37:37] okay. Little content. What'd you say, do we need the content more than we do?

AE: [00:37:43] Not. Okay. Good. There are a couple reoccurring dreams that people have that

are stress

CA: [00:37:49] dreams, snakes,

AE: [00:37:52] snakes, possibly spiders, fish.

What are we going? Fish is your thing. Big weirdo teeth falling out.

CA: [00:38:01] I've never had a reoccurring dream about my teeth.

AE: [00:38:03] That is a reoccurring stress dream that a lot of people experience.

CA: [00:38:07] Uh, how often have you experienced the teeth falling out dream? I have never.

Okay. So, other people have a fear for sure.

AE: [00:38:14] Sure. Yes. Um, but I'm going to be talking about the evolution of dentistry.

Oh, how fun. Okay. This

was fun. Um, horrifying. You be the judge.

CA: [00:38:28] Perfect. Already SIG intersectionality.

AE: [00:38:30] All right. Let's set the scene. We are going back to 5,000 BC to Mesopotamia.

Okay. The Sumerians wrote a text describing a tooth worm, which would have caused a lot of

dental decay.

What we know now is cavities. Um, this concept was taken very seriously. They thought that

this tooth worm could have been the cause of, of all of our, uh, dental issues up until the 18th

century. Wow. They believed in this. Yes.

CA: [00:39:02] Oh my gosh. That's such a long time.

AE: [00:39:04] Yep. Sometimes dental providers, which were not necessarily dentists and we'll

kind of cross that bridge soon, but, um, they would pull on the nerves of the teeth because they

thought that they were worms.

Oh,

CA: [00:39:18] okay.

AE: [00:39:19] I just had to reach out to, I know there's going to be a lot of that. I didn't realize

how sensitive it is because a lot of people have a fear of the dentist, right? Yeah. Okay. I'm not

one of those people, me. Um, but luckily I've, I've had pretty good feedback from my dentist

throughout the years, and I have access to regular dental visits and all that jazz, but it's a real

fear that people have.

And as I was writing my notes, I was like, Oh Mike, like I kept reaching up to my mouth. It's

really horrifying. And I, and I understand it was probably the most anxiety I've had around my

teeth in a long time. Wow. In 1911, a discovery was made in Slovenia and the town of loca,

which was believed as one of the first fillings.

Which dated back to 4,000 BC. Wow. And the fillings in the teeth were actually made of bees

wax. It's very interesting.

CA: [00:40:08] Um, it's interesting. I mean, I can't imagine a better substitute, but I also can't

imagine a worse substitute than being

AE: [00:40:16] came up with a lot of interesting ideas, which we'll cross that bridge.

Um, in 3000 BC, the Egyptians already had dentists. They were way ahead of the game. Skulls

found in 3,900 BC were found to have, uh, small holes drilled into their teeth. Hmm. Okay. Most

likely to drain abscesses. They were also one of the first to develop toothpaste. And this would

have made, um, would have been made of dried eggshells, Mer, a lot of other kind of earthy

textures.

Okay. Opium was also used for pain management. Of course it was, which is fascinating. Um,

and they also believe that touching the tooth, like, uh, like let's say your tooth was hurting, they

would say touching the tooth with a dead mouse may have relieved some of the pain.

CA: [00:41:08] Um, you want to know why it's because your brain suddenly so much more

concerned about the dead mouse coming towards your face than it is the two

It's like when someone steps on your toe so that your hand starts hurting, right? Let's

AE: [00:41:21] redirect this fear. Exactly. Also mice are so gross. These are also, I mean, this is

like pre plague, but like I can never look at mice. The same in Italy in the eighth century, BC was

where we first saw the first pair of false teeth or dentures.

Uh, they would have been made of human or animal teeth and held together with gold wire,

Greece in the fifth century, BC, our boy Hippocrates wrote about, uh, decaying teeth and gum

disease.

CA: [00:41:55] You know, I really hate that. We had no idea how much Hippocrates. So it's

going to come up.

AE: [00:41:59] This is actually a podcast about him.

CA: [00:42:02] I mean, he's what this is episode like three or four. I think that we've talked

AE: [00:42:06] about him. He keeps coming up. He was apparently very intelligent. Word on the

CA: [00:42:11] street. I mean, he was hanging out with Plato and Socrates, so, so, um, the

AE: [00:42:17] first toothbrush didn't hit the scene until the Tang dynasty in China. This would

have been made of hot hog bristles.

Similarly in Japan, they would have used horse hair. Um, monks did a lot of the medical

procedures in the 12th century. Um, mostly because they were some of the most educated at

the time, right. And in 1130, um, quote, a series of paupal edicts, prohibited monks from

performing any type of surgery, bloodletting or tooth extraction.

Barbers often assisted monks in the surgical ministry because they visited monasteries to shave

the heads of the monks and the tools of the barbers trade, sharp knives and razors were used

for surgery. After the edicts barbers assumed the monk surgical duties, bloodletting Lansing,

abscesses, extracting teeth, et cetera.

So barbers were essentially doing a lot of the surgical aspects, right? So let's say your Barbara

was busy. Who else might do this? Right? Perhaps you could also go down to your local

blacksmith to get your tooth pulled. So really

CA: [00:43:32] like a blacksmith for like a horse shoes. I don't know that that's who I would have

trusted.

I mean, you'd be like, there's no, if

AE: [00:43:41] these people should be trusted first, basically you're going to the people who

have the tools. Right, right. And that sucks for them, but we are going to be moving forward to

kind of the tutor period, the early 1400 or the 14 hundreds to the sixth to the early 16 hundreds.

Um, this is when sugar became highly important and it became, um, a very status, um, item. So

it became a symbol of status. For example, you may serve a sweet baked, good or treat after

the end of a meal. So similarly to a lot of things during this time, it started out the wealthy then

kind of trickled down to some of the lower class families.

Um, but regardless sugar was being consumed and in its raw form. So sugar would have

arrived to the home in kind of like a loaf, basically like a brick. It kind of looked like a salt lick.

Um, so a lot of labor was behind breaking down this large clump of like heavily densed sugar

grinding, turning it into granulated sugar.

Like we know today would have been like very intensive, very labor intensive. Right. Um, and so

of course, a lot of people are consuming sugar. So what goes along with that? Cavities cavities

the worms in your teeth, the worms in your tea fees. Um, so a lot of toothpicks were used tooth

cloths. We're also used to clean your teeth.

Um, they had powders and pastes and a lot of times those included sugar or honey in them,

counterparty, which is not great for your tune.

CA: [00:45:26] I mean, we know coconut oil is good for your teeth, but sure, honey,

AE: [00:45:32] not so much. No, they may have used alabaster sticks or sometimes a powder

and the powder would have been made from coral, gravel and pumice stone.

Oh my. But those are things

CA: [00:45:43] you should be putting into your

AE: [00:45:44] mouth though, would basically strip off your enamel. So they were using these

really, really abrasive. Or they

CA: [00:45:52] were using things with sugar in them. So it was either contributing to your

cavities or stripping your cavities or you're stripping your teeth of

AE: [00:45:59] enamel.

I'm also what happens when you use these really harsh chemical or harsh granulates you strip

your teeth of your enamel and then you are rinsing with these sugary things, then the cavity's

have much better access to your teeth. Yeah. So super problematic. Um, one of the things I

researched was kind of tooth health throughout time.

And what we know is that in the Viking era, people's teeth were really, really healthy and their

diet was really bland. I mean, they were eating potatoes starches, there wasn't sugar in their

diets. So I mean, based off of this information, it's a clear correlation between dental health, um,

also physical health.

That

CA: [00:46:44] is so interesting because. I mean, I never, I've never in my life thought about

Vikings teeth and

AE: [00:46:52] also, um, correlates with the length of your life too, right?

CA: [00:46:56] Yeah. No, you got to have those good strong teeth and be healthy so

AE: [00:46:59] that you can eat all the food dude and fight people and shit. And just like, God

stay alive.

I mean, this is, I nibble. I answer well, many other problems right now, you know? Yeah. They

had something called kissing comforts.

CA: [00:47:15] I am here for that sign me up,

AE: [00:47:18] which were essentially suites. And, um, the intention of these were to take away

bad breath. However, they did nothing for your tooth decay. So again, very sugary.

CA: [00:47:31] So they did nothing for you, but they did plenty for the people around you.

AE: [00:47:35] Exactly. For, you know, every, all the blacksmiths and the barbers are, their

businesses are on the rise. I'm super

CA: [00:47:42] thankful that I have to smell your stinky breath when you show up.

AE: [00:47:45] Right. Um, one of the things that's super interesting to me is that, um, the sugar

thing was really about status.

So they turn sugar into all these different non, um, dessert things. Like they would make like

meat that looked like sugar or sugar that looked like meat. Hm. They would make, um, like

canned sugar into all kinds of different forms that looked like other foods. Interesting. And I think

that was a power move.

I mean, we still do that today with like, uh, what are all

CA: [00:48:19] those like baking, baking shows where they're like, make this cake look like a

piece

AE: [00:48:23] of pizza. Yup. Yeah. But sugar is now like. A dollar. And, um, at the time it was

like this really, really, um, glamorous thing.

CA: [00:48:34] Yeah. Luxury item.

AE: [00:48:37] So some intersectionality coming on up.

Oh, they completed a census each year. So this was not a 10 year census buddy, a yearly

census in 1592, they began to collect data about deaths. They recorded them in categories

based on cause of death. So categories included, plague, Ricketts, spotted

CA: [00:49:03] fever,

AE: [00:49:05] consumption, drowning fever. And yes, teeth.

CA: [00:49:14] I would, I love to find a death record for somebody and the reason of death, just

say teeth to exempt the ambiguity of that, especially in 2021 is so funny.

Yeah. There were a lot more like how

AE: [00:49:28] miserable? Oh my God. Like tooth pain is the worst it's undescribable. It really is.

I keep thinking about Castaway. I mean, you're tooth enough. You like shove an ice skate in

your mouth. Yeah. You know what I mean? Um, but those were not the only categories. Those

were just some of the ones I found the most interesting.

Um, but for example, I saw that, um, I saw the actual documentation. It was by week. Okay. So

plague, for example, had 308 deaths that week.

CA: [00:49:58] So this is the 15 somethings. Is this the bubonic plague?

AE: [00:50:02] Yeah. Yeah. Okay. And teeth had 113. Wow. So a third. So you think, I mean,

the plague wiped out 50% of the population in Europe.

Yeah. So, um, teeth obviously is coming in a third of that coming in hot. Um, so how can you die

from bad teeth?

CA: [00:50:27] Uh, lots of avoiding the dentist,

AE: [00:50:33] right. And the answer is pretty gross. So let's say you have a lot of tooth decay

happening. Okay. So it's also affecting maybe the bone of your teeth. This might cause an

abscess.

Um, this can then like the abscess can then drain into your mouth. I'm so glad we

CA: [00:50:53] ate before

AE: [00:50:54] that, which then would most likely be swallowed. Okay. And then ultimately

you're ingesting poison.

CA: [00:51:02] Ooh. Okay. Hang on.

AE: [00:51:06] She, as she takes it, drink. Alright, go hairs to tooth decay. So it can also get into

your bloodstream.

CA: [00:51:17] Oh, I mean, that makes sense. Uh, sepsis and

AE: [00:51:20] other, the root of the tooth. Right? So, and that can cause major damage

internally. So think about it at the time. Um, people are kind of Sol because sugar is affecting

their, um, bodies, their, their hearts, um, in different ways. And then their tooth decay is also

maybe harming their heart valves, rather

CA: [00:51:45] other places, but now on their skin infections, in their

AE: [00:51:49] blood, it is not ideal.

Aren't you glad you came today to discuss this?

CA: [00:51:56] We really picked two uppers.

AE: [00:51:58] Um, but I think it's super interesting. I think it's like that weird. Part of our brains

that is intrigued by undesirable outcomes for other people,

CA: [00:52:10] Schaudenfreude yeah, darling Schaudenfreude is the German word for taking

pleasure in someone else's misery.

Um, not that I'm taking any pleasure in this, but I'm gagging. Yeah. Not fun

AE: [00:52:26] without antibiotics, which is the weirdest way I've ever pronounced it. Right.

Anni-biotics that

CA: [00:52:33] would be a great burlesque name.

AE: [00:52:37] Yes. It would be a great burlesque name, antibiotics. Um, the only option at the

time was to pull your teeth out, pull that shit out, get them gone.

Bye-bye um, so they used forceps. And the Pelican was one of the most common extraction

tools, which I will put up on the Instagram, but the dental Pelican was invented in the 14th

century and was often made by the village blacksmiths needing little skill to use and often cause

terrible damage to the teeth.

And of course, a lot of pain. So I had kind of a tendency to crack the tooth. And when you crack

the teeth, it's less likely that you're, we're gonna be able to get it all out. Right. So we know that,

you know, when people get their wisdom, teeth out, was your, where your teeth and packs did

you just want to

CA: [00:53:35] pluck them and not have tagging mountain cherries or?

AE: [00:53:38] Yeah. So the Pelican was replaced by the dental key in the 17 hundreds, which

looked like picture a wine key, the traditional wine key that looks like a tea. Uh, huh, like a

corkscrew. Um, it's going to look like that, but with a more straight end instead of the spiral.

Okay.

CA: [00:54:00] I think I've seen one of those. Do you remember going to old Salem?

Well, like as a kid for school field trip or something and seeing all the old tools that they had

there,

AE: [00:54:09] I, I, I did that, but I don't remember the tooth

CA: [00:54:14] also very possible, but I just saw something that looks like what you're describing

and I didn't know what it was for. So will also

AE: [00:54:20] be on the Instagram.

Perfect. We might need a whole Instagram post related to these dental tools because they are

wild. Um, but it was replaced by the modern forceps in the 20th century. Okay. So the, you just

pulling your teeth out with all kinds

CA: [00:54:38] of stuff. I don't love any of this.

AE: [00:54:41] I know, but it's so

CA: [00:54:43] fascinating. It's like a car accident I can't look away, but I don't love it.

So

AE: [00:54:48] as time goes along, we have people who are beginning to quote specialize in

these surgeries. So in 1723, Pierre for Schwab, a French surgeon is credited as being the father

of modern dentistry, where you are going with that published a book called the surgeon dentist.

And this was one of the very first books to give directions on how to clean your teeth, how to

care for your teeth and kind of, um, and how to treat common ailments related to teeth.

He also quote introduced, I put that in parentheses because we remember back to episode

three, not necessarily dental prosthetics. Okay. So we heard about, um, You know, fake teeth

being like put together with wire. So he's not the one that invented, this is what I'm trying to say,

CA: [00:55:50] but he's, he's tasting and credit for

AE: [00:55:53] it.

Yes. Um, he was also one of the first to note that acid from the sugar was contributing

CA: [00:55:59] to tooth decay. Well, I mean, when you narrow down all the options, that one

seems pretty. Yeah. He was like, wait

AE: [00:56:05] a second, wait a second. You

CA: [00:56:08] suddenly have access to this. And now we have all these

AE: [00:56:11] issues weird, but also at the time they have access to so much shit they didn't

have.

Right. That's that's fair, judging too harshly. I mean, the slave trade created things for Europe

and surrounding and even the United States, um, at such a cheap price. Right. Everything was

affordable, right? Yeah. So there was a huge influx of products going out just worldwide.

Dentures became more popular during this time, depending on your situation, it may have been

less painful to extract all of your teeth.

Okay. So those are your options. Either live in pain forever, or pull your teeth out, I'm going to

get dentures and then get really uncomfortable dentures, which totally sucked. That's a direct

quote, somebody I'm

CA: [00:57:00] sure. Yeah. And, uh, that we're, I mean, we're going to talk about what types of

dentures were available.

We sure are. Okay, great.

AE: [00:57:09] Good. There's common theme. Um, ivory dentures were the most popular

CA: [00:57:15] and also pretty problematic.

AE: [00:57:17] Oh, for sure. Not only are we talking about, um, like elephant ivory, we're talking

about, um, hiphop hippopotamus, hippopotamus. Yeah, really just all the babies. It sucks. Um,

but the next.

Possibly worse, possibly not, um, is human teeth that's.

CA: [00:57:37] So I remember being in kindergarten and learning that George Washington had

fake teeth, but I was told that they were wooden teeth. They were not, and they were not, they

weren't. And I've learned that since then, but I mean, it goes back to white washing history.

Right?

AE: [00:57:52] Well, in teeth has also like less, it's more palatable for, uh, children. Okay. Sure.

CA: [00:57:58] But I mean, I did use

AE: [00:58:01] wood, they did try a lot of different things. Okay.

CA: [00:58:05] But he's still use human teeth. He used human teeth,

AE: [00:58:07] like the teeth of slaves. Well, so my next point is how, or where did we get these

teeth? Can I jump the gun for you?

I'm so sorry. That's okay. We'll have you do 10 hail Mary's and drink three bloody Mary's and

that will be your penance. Um, done sometimes, um, healthy, uh, Teeth owners, Havers, um,

would sell their teeth

CA: [00:58:34] if they needed

AE: [00:58:35] like the money, if they needed the money. So similarly to, like, I was about to say

pretty women, little women when they sold their hair.

Yeah. I mean, if you've got healthy teeth and you really need the money, you can sell your

healthy teeth

CA: [00:58:48] or like gift of the magic where the woman sells her hair to get a chain for her

husband's watch. And he sells his watch to take home for her hair.

AE: [00:58:58] Oh, oftentimes in the majority of times, these were sourced from battlegrounds

and graveyards.

CA: [00:59:05] All right.

AE: [00:59:06] History. Isn't pretty, none of the research I did involved, um, using the teeth of, of

slaves or anything like that. Oh, that's good to hear, I guess. But, um, they were mostly either

donated or pulled from like cadavers. Exactly.

CA: [00:59:20] That's more palatable than what I was imagining.

AE: [00:59:23] Yeah. I, it, it sounds better to me.

I mean, there was a lot of, um, I mean, there was a lot of death at the time. Right. So kind of like

an organ donation situation there. Like I'm sure this person will,

CA: [00:59:34] yeah. It's not like we're still in ancient Egypt and you've got to have all of your

pieces in the jar.

AE: [00:59:39] Right. Also they were way ahead of all this.

So my next quote, which we've already talked about is it's very highly likely that George

Washington's teeth were not made of wood, but most likely animal and human teeth put

together with wire, which would have been very uncomfortable. Well,

CA: [00:59:55] it just, it cannot be comfortable like thinking about the roots of teeth.

I mean,

AE: [01:00:00] yeah. Yikes. Um, porcelain dentures then replaced the others. And at the time

these had a tendency to crack. However we use porcelain now, but of a different kind. Right.

And we also use resin composite materials now for veneers, which is the most popular of the

yeah. Denture or equivalent. Um, and this is when it's permanently sealed to your actual teeth.

So your tooth is rooted to your mouth. Okay. Sometimes they can do it either two ways where

they, they extract your teeth and they drill into your bone, or they can put it like a cap around

your tooth.

CA: [01:00:41] Okay. Thank you for explaining that. To me, I've always been curious, but never

curious enough to actually do the research

AE: [01:00:45] and figure it out myself.

My sister-in-law is a, um, works in a dentist office. So you have the insights coming out. If I said

that, um, in 1840. The very first dental college was opened and it was the Baltimore college of

dental surgery. Oh, surprisingly Alabama was the first state to lead the way in dental regulation

by enacting the first dental practices act in 1841.

CA: [01:01:14] I mean, ideally those would have happened in the same place, but sure. So,

AE: [01:01:20] um, it was a year later, um, Colgate mass produced the first toothpaste in 1873

and toothbrushes followed a few years later. The first African-American to earn a dental degree

was an 1869. And the first female dental assistant was employed in new Orleans in 1885.

Quote, most Americans did not adopt a good brushing habits until after world war one. There's

some intersectionality there. Yeah. When soldiers stationed abroad brought the concepts of

goods and oral health back to the United States, So the idea of oral hygiene being a new thing

is relatively correct. Um, I think everybody was just trying to figure out what was right and

understanding that health practices, um, which we take for granted every day.

We're not always so obvious. And that's my story. I am still

CA: [01:02:18] taking notes. Excellent job. Um, I feel like I have learned so much from you

today. Um, and I cannot wait to see these pictures. Like I'm going to need the inside scoop

before we start posting things on Instagram. Like before we leave today, I'm going to want to

see these picturing

AE: [01:02:35] just like envision your worst nightmare.

And that's what it was like.

CA: [01:02:38] And I suddenly have a new fear of the dentist. I get it. Now, all these people

have been talking about

AE: [01:02:44] for all these years. Everybody needs to be sure to

CA: [01:02:47] floss. Yep. And if you have dreams of your teeth falling out, it's time you go to

the dentist.

AE: [01:02:52] What's time. You slow down. Take a chill pill because, Oh, is that

CA: [01:02:55] stress-induced okay.

Yes. Um, still probably a good idea to go to the dentist

AE: [01:03:02] as much as you can. You want to pause before we do intersectionality

CA: [01:03:05] really quickly before we do it intersectionality. Um, I have this really interesting

conversation recently with a, um, a person I'm working with who asked me if I remembered the

pink tablets that you would get at school when you were like in elementary school and you

would have to chew them up and they turned your plaque pink, and then you did dope fluoride

swished.

No,

AE: [01:03:27] that never happened to me. Really? Did that happen to you? It did. So what was,

wait, what grade would this have been?

CA: [01:03:33] I mean, this was every year from kindergarten through at least fourth or fifth

grade, I think. Oh, but it was so embarrassing because you would take this tablet and suddenly

your whole mouth will be pink, but you've been at school for a solid, like few hours before you

get this nasty.

And then everyone remembers whether or not you are a person who'd brushed your teeth and

eaten for the day, but it was. I I think, and maybe I'm wrong about this, but I think it's because

like, it was a small rural, not afluent community. So I'm wondering if the impact of that was that

like, they weren't expecting our team outcomes to be good.

So they were trying to figure out how to get us more fluoride and teach more about brushing.

But it's so interesting because he is the person I was talking to is like in his fifties and he

remembered doing it. I saw his flashbacks. He, I mean, it's traumatic.

AE: [01:04:28] Um, that's so interesting. Now I went to elementary school in Delaware, so like

we had a first and second grade class that was combined and I don't remember.

I don't, I don't know that we did that. You may not

CA: [01:04:43] have. Um, I was just curious. Yeah, I'll have to do some research

AE: [01:04:46] on it. That's interesting. It's like shameful and also really effective. Absolutely.

CA: [01:04:52] It's a combo. Yeah. Okay. Well, I think the first intersectionality that I wrote down

in the very middle and probably our most surface level one is the census and the impact of the

census on how we process information historically and currently, which is really interesting,

especially given it's two very different censuses.

Like yours was a yearly census and mine was a ten-year like us census.

AE: [01:05:23] I think that the census that they were doing was done, uh, on a weekly basis to

be compiled for a yearly gotcha. Overall

CA: [01:05:33] census. Right. It was an ongoing record, like an

AE: [01:05:36] ongoing record records. Right. Okay. Because there was so much death going

on because it was so terrible to live well in these times

CA: [01:05:47] still relatable.

Um, but

AE: [01:05:51] no, I don't know. Have you, has anybody ever asked you, like, if you could live in

any other time, like what time was it? 11 and I always say, no, I'm not living in any other fucking

time because I can vote and I can get a coronavirus vaccine. And like, no,

CA: [01:06:13] I would love to visit another time, but I want to come back to my dentist

afterwards.

Exactly. Um, speaking like real quick aside here. Um, and I, maybe this is one of the

intersectionalities, like. And it's not something that you touched on specifically, but knowing that

access to services, mental health or physical health, like dentistry is inaccessible, or has not

always been super accessible for certain populations, which is just an interesting topic

altogether.

And we might come back to that in a second, but, um, for the first time in my life, I'm going to a

dentist that the office is all female and all women of color. Oh, I love that, which is so cool. Um,

And it wasn't something I'd ever even thought about until I needed a new dentist and this one

just popped up as being highly recommended.

So I've always only ever gone to white man and

AE: [01:07:10] yep. I think that's, uh, an predominant figure in most industries and I think it's

important to actively choose other kinds of, of diversity in, um, yeah.

CA: [01:07:24] Business. Yeah, I agree. And I think that it's interesting because I mean, who is

historically had access to education and has had access to, um, research or the ability to even

do the research?

Um, it's been white men, so of course they've been ahead of the game because they've had

access to knowledge and information for generations that women and people of color have not

had.

AE: [01:07:50] And my time period is very Europe kind of focus. Century. So the majority of the

population is, is white, right? It's it's more of a classist situation.

So the, the lower class people were having to still go to these, like the bar, like your barber to

like cut your teeth out. Are you kidding me? I mean,

CA: [01:08:12] they were going to the barber for bloodletting, with headaches and all sorts of

other things too. Like the barber. The, the field of being a barber has really whittled down to just

doing hair, but that's relatively new still.

Oh God.

AE: [01:08:26] How horrible is that? Another thing I have is that we do discuss similar time

periods.

CA: [01:08:31] Yeah. So speaking of certain time, period, you mentioned world war one, I

believe. And how that impacted dental practices. Mine was world war II. Oh, mine was world

war II as well. I don't know why I heard world

AE: [01:08:45] war one.

Yeah. Yes. World war II. There we go. Intersectionality world war II.

CA: [01:08:49] Yeah. So I think that, um, and again, it goes back to having resources available

to people and places of privilege and vets have experienced horrific things. Like I don't want to,

uh, like this credit, this credit there. Mental health experiences or the physical experiences that

they've had, but coming back from world war two, things obviously changed pretty drastically in

the fields of mental health and physical health.

Yeah.

AE: [01:09:21] So, and continued to evolve, I think after a lot. Well, from our, I mean, we live in

the U S so I know after Vietnam, there was a large, like a need for more mental health support

for veterans as well. And there was also the, the pushback from the Vietnam war in general. Oh,

absolutely. Talking about today, but possibly later.

But what I thought was interesting about my portion from world war II was that they had to go

outside of their current, like wherever they lived to, to experience more, more hygiene. That is

really interesting. Hygenic yeah. And from history portion that I discussed was non-European

like the early. Dental hygienic, uh, credit goes to

CA: [01:10:10] super and

AE: [01:10:10] Egypt, right?

Correct. Yeah. Yeah. Yeah. So that's, and, and even, uh, China and Japan.

CA: [01:10:18] Yeah. I think if we were to trace mental health back, even further than the 1840s,

I mean, people across various cultures have been treating mental health differently often in

Christian society, they're exorcisms that are associated with mental health or just kind of putting

people away or whatever else.

So it's interesting too, like how far back you trace it and what the impact of that is, people relate

to and create a world based around what they already understand. So like, Exactly. So thinking

about ancient Mesopotamia and the worms and the teeth, like imagine an Apple that you are

eating or pomegranate, I think pomegranates were probably more prevalent in Mesopotamia.

I don't really know, but, um, but imagine like the worm going in the Apple, right? Like that's what

you see and that's what your tooth looks like then, so it makes so much sense.

AE: [01:11:13] Well, and also the think about how a cavity looks, it looks like something's

burrowed in. Right? Right. So, I mean, it's a natural kind of assumption.

Oh, absolutely. To, to think there might be a worm or, you know, a parasite, you know, they're

experiencing those things at around a similar time. I mean, people experiencing them now as

well, but yeah, I think the discovering and trying to understand why things happen. You create.

You creating the solutions and realities.

Exactly. And, but I mean, it really is that tooth worm thing. I mean, that, that

CA: [01:11:51] went from, it's going to give me nightmares tonight. It will have nothing

AE: [01:11:54] to do with BC too. Like what did I say? The 18 hundreds. Yeah. Pretty much until

our, our French, uh, gentlemen gentle mall, um, wrote his law

CA: [01:12:07] book, which is just wild.

Like, it makes so much sense. And of course when we don't have an explanation for something,

we create an explanation. Yeah. Totally natural. So

AE: [01:12:20] great job intersectionality or anything that we're forgetting intersectionality wise?

Probably. Yeah. Yeah. I'm pretty sure 1000%, but that's okay.

CA: [01:12:31] Yeah. Um, you know, if you can think of another intersectionality, leave us a

note.

I'm curious, like drop us a line. Shoot, email. Yeah. Carrier pigeon. Whatever you got, send

AE: [01:12:45] it our way smoke signal, all of which are appreciated.

CA: [01:12:49] Yep.

AE: [01:12:50] Um, all right, well, thank you guys so much for listening. You can find us on our

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CA: [01:14:13] and if you're out there, keep listening.

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