# Sonic Poison? The Genesis of Havana Syndrome

An episode of [Cautionary Tales with Tim Harford](https://invisiblenetwork.ai/podcast/1484511465), 9 Jun 2023, 37 min.

Audio: https://podtrac.com/pts/redirect.mp3/pdrl.fm/18db03/tracking.swap.fm/track/SxlTEPDY7xDg35RXkASs/traffic.omny.fm/d/clips/e73c998e-6e60-432f-8610-ae210140c5b1/c0ae8c6e-22f0-4e9b-ac1c-ae390037ac53/930fd240-4f84-4a42-8bdd-b01a011d4e7e/audio.mp3?utm_source=Podcast&in_playlist=7f5a4714-6b10-4ccf-a424-ae390037ac70

CIA agents in Havana complaining of mental fog, dizziness and ear pain in 2016. Children in Miami in 1974, hyperventilating and wracked with abdominal pain. A medieval outbreak of the “dancing plague”. A chorus of meowing nuns. These mysterious and seemingly disparate events may have a simple explanation — and one that’s often overlooked when it comes to understanding strange new syndromes. For a full list of sources used in this episode visit Tim Harford.com. See omnystudio.com/listener for privacy information.

## Transcript

[0:15] Speaker 1: Pushkin Havana, Cuba, in the fall of twenty sixteen. The
[0:24] Speaker 1: island's longtime ruler, Fidel Castro, an implacable foe of the
[0:29] Speaker 1: United States, has just died. What upheavals, what power struggles
[0:34] Speaker 1: his passing might set in train, are of considerable interest
[0:39] Speaker 1: to America's intelligence agencies. In a pleasant neighborhood of the Capitol,
[0:45] Speaker 1: one of the CIA's agents has returned home for the evening,
[0:50] Speaker 1: fairly certain in the knowledge that Cuban operatives have him
[0:54] Speaker 1: under surveillance, and then the American feels as if he's
[0:59] Speaker 1: been hit by a beam of sound. Young and fit
[1:03] Speaker 1: at the time of the incident, the agent eventually seeks
[1:07] Speaker 1: medical attention at the clinic in side the US Embassy.
[1:11] Speaker 1: He's been having headaches with acute pain in one ear,
[1:15] Speaker 1: and his hearing in general isn't what it was. Two
[1:18] Speaker 1: other officers soon say they too remember strange, sharp and
[1:23] Speaker 1: disorienting sounds in their homes. Around the same time, a
[1:28] Speaker 1: few more reports come in. The wife of one embassy
[1:31] Speaker 1: official says she heard a strange sound and looking out
[1:35] Speaker 1: the window, saw a van rush by. Was a Cuban
[1:38] Speaker 1: operative at the wheel? You need to call a meeting,
[1:42] Speaker 1: one diplomat tells the head of the American mission, the
[1:45] Speaker 1: rumor mill is going mad, so he does. He tells
[1:50] Speaker 1: the embassy staff that they may be being targeted by
[1:53] Speaker 1: some kind of unknown sonic weapon, And after the meeting,
[1:58] Speaker 1: cases of Havana syndrome explode. Staffers and their families report
[2:04] Speaker 1: hearing the strange sounds at home, even in some cases
[2:08] Speaker 1: a hotel room. They complain of dizziness, mental fog, ear pain,
[2:13] Speaker 1: and headaches. By summer twenty seventeen, news was getting out.
[2:19] Speaker 1: At first, the US State Department guardedly said they were
[2:23] Speaker 1: looking into incidents which caused the variety of physical symptoms,
[2:29] Speaker 1: but a journalist from the Associated Press got officials to
[2:33] Speaker 1: speak off the record. He reported their belief that this
[2:37] Speaker 1: was some kind of advanced device that operated outside the
[2:42] Speaker 1: range of audible sound. Soon the official language became more assertive,
[2:49] Speaker 1: not incidents, but attacks. Then President Donald Trump said he
[2:55] Speaker 1: believed Cuba was responsible. In October, the Associated Press published
[3:01] Speaker 1: another scoop, then obtained one of the recordings of the
[3:06] Speaker 1: mysterious sounds that led to suspicion of a sonic weapon.
[3:12] Speaker 1: The recordings themselves are not believed to be dangerous to
[3:15] Speaker 1: those who listen, wrote the Associated Press. Sound experts and
[3:19] Speaker 1: physicians say they know of no sound that can cause
[3:22] Speaker 1: physical damage when played for short durations at normal levels
[3:26] Speaker 1: through standard equipment like a cell phone or computer, so
[3:31] Speaker 1: I should be safe in playing it to you. How
[3:42] Speaker 1: to describe the sound, the Associated Press had to go
[3:47] Speaker 1: It sounds sort of like a mass of crickets. What
[3:52] Speaker 1: device produced the original sound remains unknown. One obvious possibility
[3:58] Speaker 1: is that the device could have been a mass of crickets.
[4:03] Speaker 1: That the sound of mere insects can't reduce the CIA's
[4:07] Speaker 1: finest to physical rex, can it. I'm Tim Harford, and
[4:15] Speaker 1: you're listening to cautionary tales. In an elementary school in
[5:05] Speaker 1: Miami in nineteen seventy four, a couple one hundred children
[5:10] Speaker 1: are rehearsing a musical. The fourth, fifth and sixth graders
[5:14] Speaker 1: are singing in the school's caffetorium. That's a room that
[5:18] Speaker 1: doubles as a cafeteria and an auditorium. At half past
[5:24] Speaker 1: nine in the morning, one eleven year old girl begins
[5:28] Speaker 1: to feel unwell. Let's call her Sandy. That's the name
[5:33] Speaker 1: the New Yorker magazine gave her. When they wrote an
[5:36] Speaker 1: article about what happened. Next, Sandy doesn't want to disrupt
[5:40] Speaker 1: the rehearsal, so she tries to slip out of the
[5:43] Speaker 1: caffetorium without anyone noticing. The teacher doesn't see her, but
[5:48] Speaker 1: some of the other children do. Sandy goes to see
[5:52] Speaker 1: the school nurse. The nurse isn't there, but the head
[5:56] Speaker 1: secretary is passing by and she sees Sandy's slump, unconscious
[6:00] Speaker 1: on the nurse's couch. The secretary takes out her smelling
[6:04] Speaker 1: salts and wafts them under Sandy's nose that Sandy doesn't
[6:08] Speaker 1: come round, The secretary calls the emergency services. They arrive
[6:14] Speaker 1: just as the rehearsal ends. As the kids file out
[6:18] Speaker 1: of the caffetorium, they see Sandy being carried off on
[6:21] Speaker 1: a stretcher. And now another child says she's feeling ill,
[6:27] Speaker 1: and another and another. Some say they're dizzy, some have headaches,
[6:32] Speaker 1: some complain of abdominal pain, some are hyperventilating. Soon, seven
[6:39] Speaker 1: more children have been rushed to hospital. Another twenty five
[6:43] Speaker 1: are sick enough that the school calls their parents to
[6:46] Speaker 1: come and collect them. What could be happening a neighborhood
[6:51] Speaker 1: doctor arrives to offer his help and immediately notices a
[6:55] Speaker 1: funny smell some kind of poison gas, perhaps leaking from
[7:02] Speaker 1: a broken pipe. Police cars join the ambulances, so does
[7:07] Speaker 1: the rescue squad from the fire department. The local media
[7:10] Speaker 1: routinely look for stories by listening in to transmissions on
[7:14] Speaker 1: the emergency services radio frequency, so word of the suspected
[7:18] Speaker 1: poison gas leak soon gets around. Reporters from newspapers turn up,
[7:24] Speaker 1: so do four film crews from the local TV news stations.
[7:28] Speaker 1: Worried parents flock to the school. They're joined by curious
[7:32] Speaker 1: neighbors and passers by. By the time Joel Nitskin arrives
[7:37] Speaker 1: to investigate, the scene is chaotic. Dr Nitskin heads the
[7:42] Speaker 1: county's Department of Public Health. He and his colleague have
[7:47] Speaker 1: to park half a block away as the street is
[7:50] Speaker 1: jammed with assorted emergency vehicles, their lights all flashing. Nitskin
[7:55] Speaker 1: is six feet nine inches tall, so he's able to
[7:59] Speaker 1: pick a path through the crowds of people. As he
[8:03] Speaker 1: enters the school grounds, Nitskin sees hundreds of children sitting
[8:07] Speaker 1: quietly in the shape of some trees, looking amused. Look
[8:12] Speaker 1: perfectly healthy. That's reassuring, Nitskin thinks. Whatever's going on, hundreds
[8:18] Speaker 1: of children are obviously unaffected. Nitskin and his colleague go
[8:23] Speaker 1: into the school building. They notice the unusual smell, but
[8:28] Speaker 1: they can't immediately place it. The school's head secretary greets them.
[8:33] Speaker 1: There's been some kind of poisoned gas leak. She tells them, Oh,
[8:37] Speaker 1: that's what she's heard. It all started with this girl, Sandy.
[8:42] Speaker 1: She started to feel ill when rehearsing a musical in
[8:45] Speaker 1: the caffetorium. Then more children got sick, dozens of them.
[8:49] Speaker 1: Some have gone to hospital, some have gone home. We're
[8:52] Speaker 1: treating about forty more now as best we can. Where
[8:56] Speaker 1: are you treating these sick children, asks Nitskin. In the caffetorium,
[9:00] Speaker 1: says the secretary. Nitskin exchanges a glance with his colleague.
[9:06] Speaker 1: In the caffetorium, that's where Sandy got ill. Wouldn't that
[9:12] Speaker 1: be where the poison gas must have been leaking, Oh,
[9:16] Speaker 1: says the secretary. I don't know about that. Nitskin and
[9:20] Speaker 1: his colleague head into the caffetorium, where, sure enough they
[9:24] Speaker 1: find children stretched out on the floor and nurses and
[9:28] Speaker 1: police and fire rescue workers buzzing anxiously around them. That
[9:33] Speaker 1: strange smell is nowhere near as strong in here, Nitskin notices.
[9:38] Speaker 1: He locates an office with the telephone and calls the
[9:42] Speaker 1: hospital where Sandy and the other children were taken. They're
[9:45] Speaker 1: doing fine, says the doctor. They all seem to be
[9:48] Speaker 1: feeling better. The lab tests haven't all come back, but
[9:51] Speaker 1: everything's coming up normal so far. Nitskin hangs up the
[9:56] Speaker 1: phone and sees another colleague from the county's environmental health department.
[10:01] Speaker 1: He's arrived separately, and he's been checking out the school building.
[10:06] Speaker 1: About that funny smell when you come into the school,
[10:09] Speaker 1: asks did you notice it? Any idea? What it is?
[10:13] Speaker 2: Sure?
[10:13] Speaker 1: Comes the reply, it's carpet adhesive. They laid a new
[10:17] Speaker 1: carpet in the library a few days ago. Is it toxic? No, who,
[10:22] Speaker 1: laughs the colleague, not at all. Have you found any
[10:25] Speaker 1: hint of toxic gas? Nope. I'll investigate further, of course,
[10:29] Speaker 1: but on a first check, everything seems normal, doctor Nitskin
[10:34] Speaker 1: ponders as he walks back to the caffetorium. He trusts
[10:38] Speaker 1: his colleague from Environmental Health. It doesn't seem to be
[10:41] Speaker 1: poisoned gas. It can't be viral or bacterial. There wasn't
[10:45] Speaker 1: time for Sandy to have infected everyone else anyway. The
[10:50] Speaker 1: kids are complaining of all kinds of different symptoms that
[10:53] Speaker 1: wouldn't make sense if it's an infectious disease. In Nitskin's mind,
[10:59] Speaker 1: the pieces are starting to fall into place when he's
[11:03] Speaker 1: accosted by a woman who works in the kitchen. You're
[11:07] Speaker 1: a doctor, right, you're in charge here, yes, says Nitskin.
[11:11] Speaker 1: I am. Then why don't you do something? Why don't
[11:14] Speaker 1: you straighten out this mess? You know as well as
[11:17] Speaker 1: I do that there's nothing the matter with these kids.
[11:19] Speaker 1: Get them up on their feet, get them out of here.
[11:21] Speaker 1: I have to start setting up for lunch. Nitskin stares
[11:25] Speaker 1: at the woman, his mouth open. She's just bluntly put
[11:30] Speaker 1: into words exactly where his own thoughts had been tentatively leading.
[11:35] Speaker 1: Now he's pretty sure he knows what's wrong and how
[11:39] Speaker 1: to fix it. Enough, says doctor Nitskin.
[11:42] Speaker 2: I've got an announcement to make.
[11:45] Speaker 1: He's soon commanding the attention of everyone in the caffetorium.
[11:49] Speaker 2: We've conducted an initial investigation into claims of poison gas.
[11:53] Speaker 1: He says, we.
[11:54] Speaker 2: Haven't found any there's no evidence of any infectious disease either.
[11:59] Speaker 1: By now the journalists are crowding round. Nitskin has cameras
[12:03] Speaker 1: on him, microphones thrust in his face. What's happened here,
[12:08] Speaker 1: he continues, is.
[12:09] Speaker 2: An outbreak of math hysteria, and it needs to stop
[12:14] Speaker 2: right now. We have to get this school back to normal.
[12:17] Speaker 2: Get these kids out of the caffatorium so the kitchen
[12:20] Speaker 2: staff can set up for lunch, Bring in all the
[12:23] Speaker 2: other kids from under the trees outside, send them back
[12:25] Speaker 2: to their classrooms.
[12:26] Speaker 1: Now bright this minute, Nitskin scans the faces around him.
[12:33] Speaker 1: Nobody says a word. The nurses look stunned, the teachers
[12:39] Speaker 1: look thoughtful. He sees his colleague nodding and smiling, and
[12:45] Speaker 1: the parents. The parents look appalled. Has Nitskin just said
[12:52] Speaker 1: that their kids are crazy? But it's as if a
[12:58] Speaker 1: spell has been broken. People start to talk to each other.
[13:02] Speaker 1: The kids who had been feeling ill perk up. The
[13:06] Speaker 1: teachers take them back to their classrooms and bring in
[13:08] Speaker 1: the kids from under the trees outside. The first responders
[13:12] Speaker 1: from the various emergency services begin to drift off. Dr
[13:16] Speaker 1: Nitskin drives back to his office, thinking I hope I
[13:21] Speaker 1: got that right. Cautionary tales will be back in a moment.
[13:35] Speaker 1: When Joel Nitzkin spoke in that Miami school cafetorium, he
[13:40] Speaker 1: described what was happening as mass hysteria. That was half
[13:46] Speaker 1: a century ago. Language evolves, and hysteria is for good reason,
[13:51] Speaker 1: no longer a medical diagnosis. It's an ancient Greek word
[13:56] Speaker 1: from Hista, meaning uterus. Hysteria was thought to affect people
[14:02] Speaker 1: with a uterus, and over the years it's often been
[14:05] Speaker 1: used to describe any kind of behavior by women that
[14:09] Speaker 1: men find annoying. Aristotle, for example, said women shouldn't have
[14:16] Speaker 1: the vote because of their hysterical disposition. As for mass hysteria,
[14:24] Speaker 1: that seems to have first become common in the Middle Ages,
[14:28] Speaker 1: especially with outbreaks of the dancing plague. Here's one historical account.
[14:34] Speaker 1: The streets were filled with men and women who joined hands,
[14:37] Speaker 1: formed circles, and seemingly lost all control over their actions.
[14:42] Speaker 1: They danced together ceaselessly for hours or days, and in
[14:46] Speaker 1: wild delirium, the dance has collapsed and fell to the ground, exhausted,
[14:52] Speaker 1: groaning and sighing, as if in the agonies of death.
[14:58] Speaker 1: People believed that they were seeing God or being possessed
[15:02] Speaker 1: by demons. Here's an especially striking case recounted by a
[15:08] Speaker 1: German physician. I have read in a good medical work
[15:12] Speaker 1: that a nun in a very large convent in France
[15:16] Speaker 1: began to meou like a cat. Shortly afterwards, other nuns
[15:21] Speaker 1: also meowed. At last, all the nuns meowed together every
[15:26] Speaker 1: day at a certain time for several hours. The whole
[15:30] Speaker 1: surrounding Christian neighborhood heard with equal chagrin and astonishment this
[15:36] Speaker 1: daily cat concert, which did not cease until all the
[15:40] Speaker 1: nuns were informed that a company of soldiers were placed
[15:43] Speaker 1: by the police before the entrance of the convent, and
[15:47] Speaker 1: that they were provided with rods and would continue whipping
[15:51] Speaker 1: them until they promised not to meau anymore. When you
[15:57] Speaker 1: hear stories like this, mass hysteria sounds like something from
[16:02] Speaker 1: a long gone age of superstition. But it still happens.
[16:07] Speaker 1: Only today we have a different name for it, mass
[16:11] Speaker 1: psychogenic illness. Psychogenic means beginning in the mind. In contrast,
[16:19] Speaker 1: an illness that begins in the body is called physiogenic.
[16:23] Speaker 1: For example, if you've breathed in poison gas, we all
[16:28] Speaker 1: find it easy to understand physiogenic illnesses. If a doctor
[16:32] Speaker 1: tells you you're ill because a bacteria or a toxin
[16:35] Speaker 1: has got into your body, you believe them. Psychogenic illnesses
[16:41] Speaker 1: are much more mysterious. How does our own mind make
[16:45] Speaker 1: us ill? And yet it does. It's lunchtime at a
[16:53] Speaker 1: secondary school in the small Belgian town of Burnham. The
[16:58] Speaker 1: year is nineteen ninety nine. As usual, the canteen has
[17:03] Speaker 1: crates of coca cola that the children can buy to
[17:06] Speaker 1: drink with their lunch. Today, something seems different, but quite right.
[17:14] Speaker 1: A buzz of conversation goes round the canteen. Does this
[17:18] Speaker 1: bottle of coke smell funny to you? Some of the
[17:23] Speaker 1: children shrug and gulp down the coca cola regardless. Others
[17:27] Speaker 1: start to drink theirs, but find that the taste is
[17:31] Speaker 1: a bit off, so they leave their bottles unfinished. Still,
[17:35] Speaker 1: others are concerned enough by the smell to take their
[17:38] Speaker 1: bottle back to the canteen staff and ask to swap
[17:42] Speaker 1: it for a new one. After this happens a few times,
[17:45] Speaker 1: the canteen staff decide they'd better stop selling the coke.
[17:50] Speaker 1: The children go back to their lessons, but Within half
[17:54] Speaker 1: an hour, several are starting to feel ill. They have headaches, nausea, dizziness,
[18:01] Speaker 1: abdominal pain. Some are having trouble with their breathing. The
[18:06] Speaker 1: school phones their medical helpline for advice, better take all
[18:11] Speaker 1: the kids to hospital. They're told to be on the
[18:13] Speaker 1: safe side. The teachers don't yet know what they're dealing with.
[18:18] Speaker 1: They decide to go round all the classrooms. Did any
[18:21] Speaker 1: of you drink coca cola at lunchtime and you're now
[18:24] Speaker 1: feeling ill? More children come forward, twenty two in all.
[18:30] Speaker 1: The teachers drive them all to the hospital at home.
[18:34] Speaker 1: That evening, still more children start to feel unwell. Another
[18:38] Speaker 1: eleven turn up at the emergency room. Investigators later analyzed
[18:44] Speaker 1: the coke the children had drunk. There was indeed a
[18:47] Speaker 1: problem with it. The gas that makes fizzy drinks fizzy
[18:51] Speaker 1: is carbon dioxide, but in bottles from this batch of drinks,
[18:55] Speaker 1: it had been contaminated by two other gases, carbonyl sulfide
[19:00] Speaker 1: and hydrogen sulfide. These are gases that smell like rotten eggs.
[19:06] Speaker 1: They can make you ill in large quantities, although the
[19:10] Speaker 1: investigators didn't find large quantities enough to cause a strange smell, yes,
[19:16] Speaker 1: enough to harm someone, They didn't think so. Still the
[19:22] Speaker 1: story is all over the Belgian news. Kids drank funny
[19:27] Speaker 1: tasting Coca cola and now they're in hospital. And soon
[19:31] Speaker 1: reports come in from different schools in different towns. Some
[19:36] Speaker 1: children are feeling ill. They drank cans of Coca Cola
[19:40] Speaker 1: light from a vending machine. We've seen the news and
[19:43] Speaker 1: we're assuming that must have had something to do with it. Actually,
[19:47] Speaker 1: some of the kids hadn't had Coca Cola Light. They'd
[19:50] Speaker 1: had Fanta that's made by the Coca Cola company too.
[19:55] Speaker 1: It soon turned out that these cans of Coca Cola
[19:58] Speaker 1: Light and Fanta had been produced at a different facility
[20:02] Speaker 1: from the coke bottles. The carbon dioxide in them is
[20:06] Speaker 1: perfectly fine, so two different problems hit two different factories
[20:13] Speaker 1: at the same time. Investigators looked into the cans too,
[20:18] Speaker 1: and they did find another problem, although it didn't seem
[20:21] Speaker 1: very serious. The wooden palettes used to transport the crates
[20:26] Speaker 1: had apparently been treated with fungicide, and that fungicide might
[20:31] Speaker 1: have reacted chemically with the chlorinated cleaning products used in
[20:35] Speaker 1: the vending machines, and that reaction might have caused a
[20:39] Speaker 1: smell on the outside of the can. Could it have
[20:43] Speaker 1: poisoned people? Didn't look plausible. Meanwhile, the storm in the
[20:49] Speaker 1: media grows. More and more reports come in, and not
[20:54] Speaker 1: just from schools or from children. Adults too become convinced
[20:58] Speaker 1: that Coca cola products are making them ill. Hundreds of
[21:02] Speaker 1: members of the public call the twenty four hour hotline
[21:06] Speaker 1: of Belgium's Poison Control Center, comporting symptoms and wondering if
[21:11] Speaker 1: they should attribute those symptoms to the fizzy drink they've
[21:14] Speaker 1: recently consumed. Most of the symptoms aren't too serious, like
[21:20] Speaker 1: the wands originally reported in the media. Headaches, nausea, dizziness,
[21:25] Speaker 1: abdominal pain, that kind of thing. But one doctor calls
[21:29] Speaker 1: the Poison Control Center hotline to ask about a condition
[21:33] Speaker 1: that's much more worrying, hemolysis, a disorder of the red
[21:38] Speaker 1: blood cells. The doctor explains that he's treating a child
[21:42] Speaker 1: with hemolysis and he's curious to know whether or not
[21:45] Speaker 1: anyone has reported hemolysis as one of the conditions potentially
[21:49] Speaker 1: linked to coca cola. Nobody has, but the doctor's inquiry
[21:55] Speaker 1: goes into the database, and when Belgium's Minister of Health
[21:58] Speaker 1: asks for a list of the possible effects of drinking
[22:01] Speaker 1: Coca cola. That list contains hemolysis. The Minister mentions the
[22:06] Speaker 1: term at a press conference. Soon after, the media finds
[22:11] Speaker 1: a hospital that's treating people with hemolysis who have also
[22:15] Speaker 1: recently drunk Coca cola. The Minister decides that urgent action
[22:21] Speaker 1: is needed. Six days after the first school children fell ill,
[22:26] Speaker 1: the Ministry of Health bans the sale of all Coca
[22:29] Speaker 1: Cola products in Belgium. The Coca Cola company puts out
[22:34] Speaker 1: a statement saying we deeply regret any problems encountered by
[22:39] Speaker 1: our European consumers in the last few days, and they
[22:43] Speaker 1: issue a mass product record for Coca Cola, Coca Cola Light, Fanta, Nesty, Aquarius, Bonaqua,
[22:51] Speaker 1: Kinletnic and Lilt. They temporarily shut down three factories. They
[22:57] Speaker 1: throw away stocks of soft drinks worth over one hundred
[23:01] Speaker 1: million dollars. Gradually, the media reports die down and the
[23:07] Speaker 1: calls to the poison hotline start to dry up. After
[23:11] Speaker 1: a couple of weeks, the Minister lifts the ban and
[23:15] Speaker 1: Coca Cola's CEO issues an abject apology. We let down
[23:21] Speaker 1: the people of Belgium. But had the Coca Cola company
[23:27] Speaker 1: let down the people of Belgium by making lots of
[23:30] Speaker 1: the meal, or had they in fact let people down
[23:34] Speaker 1: by not being more like no nonsense? Dr Nitskin cautionary
[23:44] Speaker 1: tales will return in a moment. After Dr Nitskin told
[23:58] Speaker 1: the children in Miami that there was no poison gas,
[24:01] Speaker 1: when they should get back to their classrooms and carry
[24:04] Speaker 1: on as normal, some parents were furious with him. One
[24:09] Speaker 1: mother called his office, demanding that he apologize for insulting
[24:13] Speaker 1: her daughter. How dare he imply that she's insane? Dr
[24:18] Speaker 1: Nitskin tried to explain that he'd done no such thing.
[24:22] Speaker 1: He had implied that she was suggestible. We all are,
[24:25] Speaker 1: he explained, to some degree. It's not a sign of insanity,
[24:30] Speaker 1: especially at the age of eleven. Here's how that suggestibility works.
[24:35] Speaker 1: I see other people feeling ill. Someone tells me it's
[24:39] Speaker 1: because of a mystery gas. I smell it too. I
[24:43] Speaker 1: expect to start feeling ill, and I do, and it's
[24:47] Speaker 1: not my imagination. I really do feel ill. Exactly how
[24:52] Speaker 1: our beliefs and expectations translate into actual, real symptoms is
[24:56] Speaker 1: still not well understood. It's one of the many mysteries
[24:59] Speaker 1: of the human mind, but there's no room for doubt
[25:02] Speaker 1: that it happens. Many people, though, seem to find that
[25:07] Speaker 1: hard to get their heads around. When a doctor suggests
[25:11] Speaker 1: that their illness might be psychogenic, the patient thinks they're
[25:14] Speaker 1: being accused of something, of imagining their symptoms or faking them.
[25:19] Speaker 1: A few weeks into the Coca Cola scare in Belgium,
[25:22] Speaker 1: some scientists publicly raised the idea that mass psychogenic illness
[25:28] Speaker 1: could have been the cause. The backlash from the general
[25:31] Speaker 1: public was immediate. What do these scientists know. They haven't
[25:35] Speaker 1: examined a single patient. Are they saying doctors were fooled
[25:38] Speaker 1: or people simply imagined their symptoms? No, they weren't. They
[25:43] Speaker 1: were saying people had real symptoms caused not by drinking
[25:47] Speaker 1: poisonous soda, but by mistakenly believing their drunk poisonous soda.
[25:54] Speaker 1: But if experts struggled to get that idea across to
[25:57] Speaker 1: an irate public, imagine what would have happened to the
[26:01] Speaker 1: Coca Cola company if they'd come out at the height
[26:04] Speaker 1: of the media storm and said, our drinks seem fine
[26:07] Speaker 1: to us, maybe it's psychogenic. It would have been a
[26:10] Speaker 1: public relations disaster. No wonder they preferred to pour one
[26:15] Speaker 1: hundred million dollars of soda needlessly down Belgian drains. From
[26:21] Speaker 1: the backlash against doctor Nitskin and the scientists in Belgium,
[26:25] Speaker 1: it seems clear that mass psychogenic illnesses are widely misunderstood.
[26:31] Speaker 1: And that's a problem because when a mysterious new syndrome
[26:35] Speaker 1: comes along, it can be hard to have a dispassionate
[26:39] Speaker 1: discussion of the possible causes. I was inspired to write
[26:47] Speaker 1: this cautionary tale about mass psychogenic illnesses by a book
[26:51] Speaker 1: recently published by two distinguished academics, Robert Bartholomew and Robert Below.
[26:58] Speaker 1: The book is well researched and it's convincingly argued, but
[27:02] Speaker 1: it also has some terrible reviews from readers propagandistic garbage,
[27:08] Speaker 1: unbribed ignorance, and pseudoscience, wild speculations, des information add its finest.
[27:15] Speaker 1: The book is called Havana Syndrome. Remember the story. It
[27:20] Speaker 1: started with an undercover officer at the US Embassy in Havana, Cuba,
[27:25] Speaker 1: complaining that he fell ill after hearing a mysterious sound
[27:28] Speaker 1: at his home. As news about the case got around,
[27:32] Speaker 1: more and more people started reporting symptoms. After hearing similar sounds,
[27:38] Speaker 1: officials became convinced that they were dealing with some kind
[27:41] Speaker 1: of sonic weapon, a weapon that sounded sort of like
[27:46] Speaker 1: a mass of crickets. The FBI took recordings of the
[27:50] Speaker 1: sounds to an expert in crickets. He listened to them.
[27:58] Speaker 1: That's crickets, he said, crickets, cicadas, or Katie did's one
[28:03] Speaker 1: of them. Probably cicadas. Actually, Cuban cicadas can be pretty loud,
[28:08] Speaker 1: he pointed out, ninety five decibels. That's about as loud
[28:12] Speaker 1: as a motorcycle engine. But could a cicada damage your hearing, No,
[28:19] Speaker 1: he said, not unless you shoved it into your ear canal.
[28:23] Speaker 1: There might, of course, have been a sonic weapon that
[28:26] Speaker 1: sounded a lot like cicadas. But think of it this way.
[28:30] Speaker 1: You're about to be posted to Havana. You're quietly taken
[28:34] Speaker 1: aside and played a recording that sounds very much like
[28:38] Speaker 1: Cuba and cicadas. You're told, we think this may be
[28:43] Speaker 1: a sonic weapon that's making people ill. You get to
[28:46] Speaker 1: Havana and one night you predictably hear cicadas. As the
[28:53] Speaker 1: authors below and Bartholomew put it, this is a classic
[28:58] Speaker 1: setup for an outbreak of mass psychogenic illness. There's another
[29:04] Speaker 1: reason to consider psychogenic explanations. Nobody seemed able to suggest
[29:10] Speaker 1: how the mooted sonic attack device might actually work. Still,
[29:15] Speaker 1: militaries don't tend to publicize their cutting edge technologies, and
[29:20] Speaker 1: some experts say it can't all have been psychogenic because
[29:24] Speaker 1: a few people's symptoms were too serious for that. Below
[29:27] Speaker 1: and Bartholomew disagree. I don't feel qualified to judge, but
[29:31] Speaker 1: I do think I can judge the quality of debate
[29:34] Speaker 1: around the suggestion that Havana syndrome might have been a
[29:38] Speaker 1: mass psychogenic illness. That debate was depressing, and not just
[29:43] Speaker 1: in the reader reviews of Below and Bartholomew's book. Senator
[29:47] Speaker 1: Marco Rubio, for example, sarcastically dismissed the idea that a
[29:52] Speaker 1: bunch of people are just being hypochondriacs and making it up. Well, no,
[29:58] Speaker 1: that's not how psychogenic illness works. Whether an illness begins
[30:02] Speaker 1: in the body or the mind, the symptoms are real.
[30:07] Speaker 1: But that leads to an other question, how do we
[30:11] Speaker 1: treat them? In London in nineteen ninety, more than fifty
[30:17] Speaker 1: school children were rushed to hospital when they started feeling
[30:21] Speaker 1: sick after lunch. They had abdominal pain, nausea, and vomiting.
[30:28] Speaker 1: They all recovered pretty quickly. You know the drill by Now,
[30:33] Speaker 1: this looks like a mass psychogenic illness, right, Actually no.
[30:38] Speaker 1: After careful investigation, it turned out that the cucumbers served
[30:43] Speaker 1: at school lunch were probably contaminated with insecticide. Lots of
[30:50] Speaker 1: things can make us ill, especially with the kind of
[30:53] Speaker 1: symptoms I've been mentioning through this tale. Fatigue, nausea, dizziness, headaches.
[30:59] Speaker 1: These are common ailments with all kinds of causes. It
[31:03] Speaker 1: shouldn't surprise us if we happened to find a Belgian
[31:06] Speaker 1: with some of these symptoms who just had a coke,
[31:09] Speaker 1: or a US diplomat in Havana who recently heard cicadas.
[31:14] Speaker 1: Diagnosis is hard and we need to keep an open mind,
[31:19] Speaker 1: especially because cases of physiogenic and psychogenic illnesses often crop
[31:24] Speaker 1: up together. The London investigators blamed the cucumbers, but they
[31:29] Speaker 1: also reckoned that some of the later cases might have
[31:32] Speaker 1: been psychogenic kids seeing their friends getting ill and thinking
[31:36] Speaker 1: themselves into illness too. Some people think that might also
[31:41] Speaker 1: have happened in Belgium. Those first few bottles of coke might,
[31:46] Speaker 1: of course, children to feel sick, and from that starting
[31:49] Speaker 1: point the problem ballooned through psychogenic contagion. Maybe that'll turn
[31:55] Speaker 1: out to be the story with Havana syndrome II, a
[31:58] Speaker 1: mix of physiogenic and psychogenic cases. We don't yet know
[32:03] Speaker 1: all the answers. The trouble is that psychogenic and physiogenic
[32:07] Speaker 1: illnesses need treating in completely different ways. If you're ill
[32:12] Speaker 1: because something's got into your body a toxin or a
[32:15] Speaker 1: virus or a bacteria, you need to figure out what
[32:19] Speaker 1: that thing is and if it has an antidote. If
[32:22] Speaker 1: the cause is psychogenic, then there isn't a cure as such,
[32:27] Speaker 1: at least if we discount the medieval method of sending
[32:30] Speaker 1: soldiers to whip the meowing nuns. But there is an
[32:35] Speaker 1: approach that makes sense. If the power of expectation made
[32:40] Speaker 1: someone ill, the power of expectation can also help them recover.
[32:46] Speaker 1: When doctor Nitskin told the children in Miami that there
[32:49] Speaker 1: was no toxic gas, they stopped worrying and their symptoms
[32:55] Speaker 1: melted away. Of course, what's an inspired diagnosis, if you're right,
[33:01] Speaker 1: looks like an arrogant rejection of your patient's experiences if
[33:05] Speaker 1: you're wrong. For every Joel Nitskin who decisively cures a
[33:10] Speaker 1: psychogenic outbreak, there's a doctor brusquely telling their patients to
[33:15] Speaker 1: snap out of it, when in fact the illness has
[33:18] Speaker 1: a physical cause that the doctor has overlooked. Joel Knitskin
[33:23] Speaker 1: knew he had taken a risk he'd have to justify
[33:25] Speaker 1: to his bosses. I'd made a bold move, he told
[33:29] Speaker 1: The New Yorker, and bold moves are not encouraged in
[33:33] Speaker 1: the bureaucratic world. The safe thing to do would have
[33:37] Speaker 1: been to close the school for the day. When the
[33:40] Speaker 1: report came back no poison gas. Sandy had a viral illness.
[33:44] Speaker 1: All the other kids thought themselves into feeling ill too.
[33:49] Speaker 1: Nobody would have blamed doctor Nitskin for airing on the
[33:52] Speaker 1: side of caution. I'm not sure that makes sense. If
[33:56] Speaker 1: a doctor tells us he thinks we've probably got a
[33:59] Speaker 1: viral illness and it turns out to be bacterial, we're
[34:03] Speaker 1: not going to get more or less upset than if
[34:06] Speaker 1: it made the opposite mistake. But we don't feel the
[34:08] Speaker 1: same symmetry about psychogenic illnesses. Nobody is happy when a
[34:14] Speaker 1: doctor makes a mistake, but the mistake of declaring an
[34:18] Speaker 1: illness to be psychogenic is the one we can't seem
[34:22] Speaker 1: to forgive. And if we wrongly see the suggestion of
[34:26] Speaker 1: psychogenic illness as a personal insult, we'll make doctors scared
[34:30] Speaker 1: to mention it. John Nitskin took a risk because he
[34:36] Speaker 1: understood how psychogenic illnesses work. He knew that if he
[34:41] Speaker 1: allowed the idea of poison gas to linger, more kids
[34:46] Speaker 1: would have felt ill, and he understood that their symptoms
[34:50] Speaker 1: would have been genuine. Those forty kids in the caffetorium
[34:55] Speaker 1: complaining of nausea or breathing problems weren't faking or imagining.
[35:01] Speaker 1: They were suffering. With one calm and authoritative statement, doctor
[35:07] Speaker 1: Nitskin cured them all. For a full list of our sources,
[35:37] Speaker 1: please see the show notes at Timharford dot com. Cautionary
[35:45] Speaker 1: Tales is written by me Tim Harford with Andrew Wright.
[35:49] Speaker 1: It's produced by Alice Fines with support from Edith Russlow.
[35:53] Speaker 1: The sound design and original music is the work of
[35:56] Speaker 1: Pascal Wise. Julia Barton edited the scripts. It features the
[36:01] Speaker 1: voice talents of Ben Crowe, Melanie Guttridge, Gemma Saunders and
[36:05] Speaker 1: rufus Wright. The show wouldn't have been possible without the
[36:09] Speaker 1: work of Jacob Weisberg, Ryan Dilly, Greta Cohne, let Al Millard,
[36:14] Speaker 1: John Schnaz, Carlie mcgliori and Eric Sandler. Cautionary Tales is
[36:20] Speaker 1: a production of Pushkin Industries. It was recorded in ward
[36:24] Speaker 1: Or Studios in London by Tom Berry. If you like
[36:27] Speaker 1: the show, please remember to share, rate and review go
[36:30] Speaker 1: on you know it helps us And if you want
[36:32] Speaker 1: to hear the show ad free, sign up for Pushkin
[36:36] Speaker 1: Plus on the show page in Apple Podcasts or at
[36:39] Speaker 1: pushkin dot Fm, slash plus

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